Classes
DEA Class; Rx
Common Brand Names; Relpax
- Serotonin 5-HT-Receptor Agonists;
- Antimigraine Agents
Description
Oral, serotonin (5HT1B/1D) receptor agonist (triptan)
Used for acute treatment of migraine with or without aura in adults
Safety of treating average of more than 3 migraine attacks in 30-day period not established
Indications
Indicated for the acute treatment of migraine with or without aura.
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
Adverse Effects
- Asthenia (5-10%)
- Dizziness (5-10%)
- Headache (5-10%)
- Somnolence (5-10%)
- Nausea (5-10%)
- Chest pain/tightness (1-4%)
- Palpitation (>1%)
- Flushing (>1%)
- Chills (>1%)
- Hypertonia (>1%)
- Hypoesthesia (>1%)
- Pain (>1%)
- Paresthesia (>1%)
- Vertigo (>1%)
- Weakness (>1%)
- Abdominal pain/discomfort (>1%)
- Dysphagia (>1%)
- Dyspepsia (>1%)
- Xerostomia (>1%)
- Back pain (>1%)
- Pharyngitis (>1%)
- Diaphoresis (>1%)
Warnings
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 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 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 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, reported on rare occasions in patients treated with 5-HT1 agonists, including patients without a history of hypertension; monitor blood pressure; drug is contraindicated in patients with uncontrolled hypertension
Anaphylaxis, anaphylactoid, and hypersensitivity reactions 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; drug is contraindicated in patients with a history of hypersensitivity reaction to drug or components
Pregnancy and Lactation
Available human data on the use in pregnant women are not sufficient to draw conclusions about 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
Drug is excreted in human milk; there are no data on effects on breastfed infant or on milk production
Maximum Dosage
80 mg/day PO.
80 mg/day PO.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Eletriptan hydrobromide
tablet
- 20mg
- 40mg