Eletriptan

Eletriptan is a prescription medication used for the treatment of migraine headaches.

• Eletriptan is available under the following different brand names: Relpax

Adult dosage

Tablet

• 20mg
• 40mg

Migraine Headache

Adult dosage

• 20-40 mg orally at the onset of symptoms; repeat dose after 2 hours if necessary
• Not to exceed 80 mg/day

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of the Eletriptan include:

• swelling,
• dizziness,
• weakness,
• headache,
• nausea, and
• rash.

Serious side effects of the Eletriptan include:

• hives,
• difficulty breathing,
• swelling in the face or throat,
• fever,
• sore throat,
• burning eyes,
• skin pain,
• red or purple skin rash with blistering and peeling,
• chest pain,
• slow heartbeats,
• pounding heartbeats,
• fluttering in the chest,
• lightheadedness,
• swelling,
• rapid weight gain, and
• shortness of breath

Rare side effects of the Eletriptan include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Eletriptan has severe interactions with the following drugs:
  • almotriptan
  • bromocriptine
  • cabergoline
  • chloramphenicol
  • cobicistat
  • dihydroergotamine
  • dihydroergotamine intranasal
  • ergoloid mesylates
  • ergotamine
  • frovatriptan
  • levoketoconazole
  • lopinavir
  • methylergonovine
  • mifepristone
  • naratriptan
  • rizatriptan
  • saquinavir
  • sumatriptan
  • sumatriptan intranasal
  • tipranavir
  • zolmitriptan
• Eletriptan has serious interactions with at least 47 other drugs.
• Eletriptan has moderate interactions with at least 165 other drugs.
• Eletriptan has minor interactions with the following drugs:
  • duloxetine
  • escitalopram
  • fluoxetine
  • milnacipran
  • nefazodone
  • paroxetine
  • sertraline
  • trazodone
  • venlafaxine

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity, including angioedema and anaphylaxis
• Ischemic coronary artery disease (CAD) (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal’s angina
• Wolff-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders
• History of stroke or TIA, or history of hemiplegic or basilar migraine because such patients are at a higher risk of stroke
• Peripheral vascular disease
• Ischemic bowel disease
• Uncontrolled hypertension
• Severe hepatic impairment
• Within 24 hr of another 5-HT1 agonist or ergot derivative
• Within at least 72 hr of treatment with the following potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Eletriptan?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Eletriptan?”

Cautions

• Only for use where a clear diagnosis of migraine established
• Sensations of tightness, pain, and pressure in the chest, throat, neck, and jaw commonly occur after treatment and are usually non-cardiac in origin; however, perform a cardiac evaluation in patients at high cardiac risk
• May cause non-coronary vasospastic reactions, such as peripheral vascular ischemia, gastrointestinal vascular ischemia and infarction (presenting with abdominal pain and bloody diarrhea), and Raynaud’s syndrome; in patients who experience symptoms or signs suggestive of a vasospastic reaction following the use of any 5-HT1 agonist, rule out a vasospastic reaction before receiving additional doses
• Overuse of acute migraine drugs (eg, ergotamine, triptans, opioids, or a combination of these drugs for 10 or more days per month) may lead to exacerbation of headache (medication overuse headache); medication overuse headache may present as migraine-like daily headaches or as a marked increase in the frequency of migraine attacks; detoxification of patients, including withdrawal of overused acute migraine drugs and treatment of withdrawal symptoms (which often includes a transient worsening of headache), may be necessary
• Significant elevation in blood pressure, including hypertensive crisis with acute impairment of organ systems, is reported on rare occasions in patients treated with 5-HT1 agonists, including patients without a history of hypertension; monitor blood pressure; the drug is contraindicated in patients with uncontrolled hypertension
• Anaphylaxis, anaphylactoid, and hypersensitivity reactions are reported, including angioedema; such reactions can be life-threatening or fatal; in general, anaphylactic reactions to drugs are more likely to occur in individuals with a history of sensitivity to multiple allergens; the drug is contraindicated in patients with a history of hypersensitivity reaction to drug or components
• Serotonin syndrome
  • Serotonin syndrome may occur, particularly during co-administration with selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase (MAO) inhibitors
  • Serotonin syndrome symptoms may include mental status changes (eg, agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea)
  • The onset of symptoms usually occurs within minutes to hours of receiving a new or a greater dose of a serotonergic medication; discontinue therapy if serotonin syndrome suspected
• Cardiac Effects
  • Cardiac adverse reactions, including acute myocardial infarction, were reported within a few hours following administration of the drug
  • Some reactions occurred in patients without known CAD; the drug may cause coronary artery vasospasm (Prinzmetal’s angina), even in patients without a history of CAD
  • Perform a cardiovascular evaluation in triptan-naïve patients who have multiple cardiovascular risk factors (eg, increased age, diabetes, hypertension, smoking, obesity, strong family history of CAD) prior to receiving the drug
  • Not for use if there is evidence of CAD or coronary artery vasospasm; for patients with multiple cardiovascular risk factors who have a negative cardiovascular evaluation, consider administering the first dose in a medically-supervised setting and performing an electrocardiogram (ECG) immediately following administration of the drug; for such patients, consider periodic cardiovascular evaluation in intermittent long-term users
  • Life-threatening disturbances of cardiac rhythm including ventricular tachycardia and ventricular fibrillation leading to death reported within a few hours following administration of 5-HT1 agonists; discontinue therapy if these disturbances occur; contraindicated in patients with Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorder
• Cerebrovascular effects
  • Cerebral hemorrhage, subarachnoid hemorrhage, and stroke were reported in patients treated with 5-HT1 agonists; some have resulted in fatalities; in a number of cases, it appears possible that the cerebrovascular events were primary, the 5-HT1 agonist having been administered in the incorrect belief that the symptoms experienced were a consequence of migraine, when they were not
  • Before treating headaches in patients not previously diagnosed as migraineurs, and in migraineurs who present with symptoms atypical of migraine, other potentially serious neurological conditions need to be excluded; the drug is contraindicated in patients with a history of stroke or TIA

Pregnancy and Lactation

• Available human data on the use in pregnant women are not sufficient to draw conclusions about the drug-associated risk for major birth defects and miscarriage
• Several studies have suggested that women with migraine may be at increased risk of preeclampsia and gestational hypertension during pregnancy
• Lactation
  • The drug is excreted in human milk; there are no data on its effects on the breastfed infant or on milk production
  • The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for drugs and any potential adverse effects on the breastfed child or from the underlying maternal conditions; infant exposure can be minimized by avoiding breastfeeding for 24 hours after treatment