Acute migraine attacks
Adult: Initially, 40 mg, may repeat after at least 2 hr if symptoms recur w/in 24 hr (2nd dose should not be taken for same attack). Max: 80 mg daily.
Indications and Dosage
Oral
Acute migraine attacks Adult: Initially, 40 mg, may repeat after at least 2 hr if symptoms recur w/in 24 hr (2nd dose should not be taken for same attack). Max: 80 mg daily.
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Renal Impairment
Mild to moderate: Initially, 20 mg. Max: 40 mg daily. Severe: Contraindicated.
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Hepatic Impairment
Severe: Contraindicated.
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Contraindications
Hypersensitivity to eletriptan. Known or suspected ischaemic heart disease (e.g. angina pectoris, MI, silent ischaemia), coronary artery vasospasm (e.g. Prinzmetal variant angina), severe or uncontrolled HTN, Wolff-Parkinson-White syndrome or arrhythmias, heart failure, previous CVA or TIA, peripheral vascular disease, ischaemic bowel disease, basilar or hemiplegic migraine. Severe hepatic and renal impairment. Concomitant admin w/ 5-HT1 receptor agonists or ergot alkaloids.
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Special Precautions
Patient at risk of coronary artery disease (e.g. HTN, DM, hypercholesterolaemia, smoker or user of nicotine therapy, post-menopausal women, men >40 yr, strong family history of coronary artery disease, obesity). Mild to moderate renal impairment. Pregnancy and lactation.
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Adverse Reactions
Significant: Medication overuse headache (MOH). Rarely, elevation in BP (e.g. hypertensive crisis).
Nervous: Headache, seizure, asthenia, paraesthesia, dizziness, somnolence. CV: Chest pain, palpitations, tachycardia, flushing. GI: Dry mouth, nausea, dyspepsia, dysphagia, abdominal pain, vomiting. Others: Weakness. Potentially Fatal: Cardiac rhythm disturbances (e.g. ventricular tachycardia or fibrillation), MI, coronary artery vasospasm, cerebral or subarachnoid haemorrhage, stroke, peripheral vascular ischaemia, GI vascular ischaemia, infarction, Raynaud’s syndrome, anaphylactic reactions (e.g. angioedema). |
Patient Counseling Information
This drug may cause dizziness, somnolence, or weakness, if affected, do not drive or operate machinery.
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Monitoring Parameters
Determine a clear diagnosis of migraine before treatment. Monitor CV status prior initiation of treatment and periodically thereafter; hepatic and renal function. Perform periodic CV evaluation for patients w/ risk factors for coronary artery disease who are receiving intermittent long-term therapy.
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Overdosage
Symptoms: HTN and other CV symptoms. Management: Supportive treatment.
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Drug Interactions
Increased peak plasma concentration w/ potent CYP3A4 enzyme inhibitors (e.g. ketoconazole, clarithromycin, ritonavir). Potential risk of serotonin syndrome w/ SSRIs or serotonin norepinephrine reuptake inhibitors (SNRIs).
Potentially Fatal: May cause additive vasospastic effect when used concomitantly w/ ergot alkaloids (e.g. ergotamine, dihydroergotmaine, methysergide) or other 5-HT1 receptor agonists. |
Food Interaction
Increased bioavailability w/ high-fat meal.
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Action
Description: Eletriptan is a selective agonist of serotonin (5-HT1B/1D/1F) receptors. It causes constriction of intracranial blood vessels and reduction of sterile inflammation associated w/ antidronic neuronal transmission, thereby relieving migraine.
Pharmacokinetics: Absorption: Well absorbed. Bioavailability: Approx 50%. Time to peak plasma concentration: 1.5-2 hr. Distribution: Enters breast milk (small amount). Volume of distribution: 138 L. Plasma protein binding: Approx 85%. Metabolism: Metabolised in the liver by CYP3A4 enzyme to the active, N-demethylated metabolite. Excretion: Elimination half-life: Approx 4 hr. |
Chemical Structure
![]() Source: National Center for Biotechnology Information. PubChem Database. Eletriptan, CID=77993, https://pubchem.ncbi.nlm.nih.gov/compound/Eletriptan (accessed on Jan. 22, 2020) |
Storage
Store between 20-25°C.
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MIMS Class
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ATC Classification
N02CC06 - eletriptan ; Belongs to the class of selective serotonin (5HT1) agonists preparations. Used to relieve migraine.
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References
Anon. Eletriptan. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/03/2017. Buckingham R (ed). Eletriptan Hydrobromide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/03/2017. Joint Formulary Committee. Eletriptan. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/03/2017. McEvoy GK, Snow EK, Miller J et al (eds). Eletriptan Hydrobromide. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/03/2017. Relpax Tablet, Film Coated (Roerig). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/03/2017.
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