title: Oral sumatriptan and almotriptan--delimiting the MAOI effect.
abstract: OBJECTIVE
  (1) To investigate whether a parsimonious model for sumatriptan pharmacokinetics can apply to oral administration; (2) for a successful model, whether a monoamine oxidase A inhibitor (MAOI-A) perturbs it; and (3) whether such a model is generalizable to oral almotriptan. These goals respond to statements in US product labeling.
  
  
  METHODS
  Extension of a previous model for subcutaneous sumatriptan. Numerical solutions to 3 concurrent differential equations were found, with prospective criteria for model acceptance based upon comparison with clinically observed data.
  
  
  RESULTS
  The model was successfully extended by inserting a time factor into the absorption phase. This extension was robust: it imitated clinical data for 3 oral sumatriptan dose sizes (both without and with a concomitant MAOI-A) and also for oral almotriptan.
  
  
  CONCLUSIONS
  A model for oral sumatriptan pharmacokinetics can be found using the differential calculus, and it is generalizable to oral almotriptan. The model suggests that an MAOI-A probably has greater effect on elimination kinetics than first-pass metabolism, and that this interaction appears to be overstated in product labeling.
authors.affiliation: EBD Consulting, 2032 Corte del Nogal #120, Carlsbad, CA 92011, USA.
authors.forename: Florian
authors.initials: F
authors.lastname: Oberhardt
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Fox
mesh_terms: D000284:Administration, Oral; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000201:enzymology; D008954:Models, Biological; D008995:Monoamine Oxidase / Q000378:metabolism*; D058825:Serotonin 5-HT1 Receptor Agonists / Q000008:administration & dosage*; D018170:Sumatriptan / Q000008:administration & dosage*; D013997:Time Factors; D014363:Tryptamines / Q000008:administration & dosage*
chemical_list: D058825:Serotonin 5-HT1 Receptor Agonists; D014363:Tryptamines; C409045:almotriptan; D018170:Sumatriptan; D008995:Monoamine Oxidase