eletriptan


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Related to eletriptan: eletriptan hydrobromide

eletriptan

(e-le-trip-tan) ,

Relpax

(trade name)

Classification

Therapeutic: vascular headache suppressants
Pharmacologic: five ht1 agonists
Pregnancy Category: C

Indications

Acute treatment of migraine headache.

Action

Acts as an agonist at specific 5-hydroxy-tryptamine receptor sites in intracranial blood vessels and sensory trigeminal nerves.

Therapeutic effects

Cranial vessel vasoconstriction with resultant decrease in migraine headache.

Pharmacokinetics

Absorption: 50% absorbed after oral administration.
Distribution: Enters breast milk.
Metabolism and Excretion: Mostly metabolized by the liver via the CYP3A4 enzyme system.
Half-life: 4 hr.

Time/action profile (decreased migraine pain)

ROUTEONSETPEAKDURATION
POwithin 2 hr2 hrup to 24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Hemiplegic or basilar migraine;Ischemic heart disease or Prinzmetal's angina;Uncontrolled hypertensionWolff-Parkinson-White syndrome or other arrhythmias involving conduction pathwaysStroke or transient ischemic attack;Peripheral vascular disease;Ischemic bowel diseaseSevere hepatic impairment;Should not be used within 24 hr of other 5-HT1 agonists or ergot-type compounds (dihydroergotamine);Should not be used within 72 hr of potent CYP3A4 inhibitors including ketoconazole, itraconazole, nefazodone, clarithromycin, ritonavir, and nelfinavir.
Use Cautiously in: Obstetric: Use only if potential benefits justify potential risk to fetus; Lactation: Doses up to 80 mg daily not expected to cause adverse effects in breast-fed infants >2 mo (NIH); Pediatric: Safety not established; Geriatric: ↑ risk of ↑ BP.
Exercise Extreme Caution in: Cardiovascular risk factors (hypertension, hypercholesterolemia, cigarette smoking, obesity, diabetes, strong family history, menopausal women or men >40 yr); use only if cardiovascular status has been evaluated and determined to be safe and 1st dose is administered under supervision.

Adverse Reactions/Side Effects

Central nervous system

  • dizziness
  • drowsiness
  • weakness

Cardiovascular

  • mi (life-threatening)
  • ventricular fibrillation (life-threatening)
  • ventricular tachycardia (life-threatening)
  • angina
  • chest tightness/pressure
  • coronary vasospasm
  • ECG changes
  • transient hypertension

Gastrointestinal

  • abdominal pain
  • dry mouth
  • dysphagia
  • nausea

Neurologic

  • paresthesia

Miscellaneous

  • anaphylaxis (life-threatening)

Interactions

Drug-Drug interaction

Blood levels and risk of adverse reactions are ↑ by potent CYP3A4 inhibitors (including ketoconazole, itraconazole, nefazodone, clarithromycin, ritonavir, and nelfinavir ); use within 72 hr is contraindicated.Concurrent use (within 24 hr of each other) with ergot-containing drugs (dihydroergotamine ) may result in prolonged vasospastic reactions and should be avoided.↑ serotonin levels and serotonin syndrome may occur when used concurrently with SSRI and SNRI antidepressants.

Route/Dosage

Oral (Adults) 20 or 40 mg; may be repeated in 2 hr if initial response is inadequate (not to exceed 80 mg/24 hr or treatment of 3 headaches/mo).

Availability

Tablets: 20 mg, 40 mg

Nursing implications

Nursing assessment

  • Assess pain location, intensity, character, duration and associated symptoms (photophonia, phonophobia, nausea, vomiting) during migraine attack.

Potential Nursing Diagnoses

Acute pain (Indications)

Implementation

  • Oral: Administer at the first sign of a headache. If after the initial dose, headache improves but then returns, dose may be repeated at least 2 hr after initial dose. If initial dose is ineffective, second dose is unlikely to be effective.

Patient/Family Teaching

  • Instruct patient that eletriptan should only be used during a migraine attack. Eletriptan is used for treatment of a migraine attack, not for prevention. Advise patient to read the Patient Summary of Information before starting therapy and with each Rx refill in case of changes.
  • Instruct patient to take eletriptan at the first sign of a migraine, but may be administered at any time during attack. Allow at least 2 hr between doses and do not use more than 80 mg/day or 3 attacks/mo.
  • Caution patient not to take eletriptan within 24 hr of other vascular headache suppressants.
  • Advise patient that lying down in a darkened room after eletriptan administration may further help relieve headache.
  • Advise patient to notify health care professional if she plans or suspects pregnancy, or if breast feeding.
  • Advise patient to notify health care professional before next dose of eletriptan if pain or tightness in the chest occurs. If chest pain is severe or does not subside, notify health care professional immediately. If feelings of tingling, heat, flushing, heaviness, pressure, drowsiness, dizziness, tiredness, or sickness develop, discuss with health care provider at next visit.
  • May cause drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
  • Advise patient to avoid alcohol, which aggravates headaches, during therapy.
  • Advise patient that overuse (use more than 10 days/month) may lead to exacerbation of headache (migraine-like daily headaches, or as a marked increase in frequency of migraine attacks). May require gradual withdrawal of rizatriptan and treatment of symptoms (transient worsening of headache).
  • Instruct patient to notify health care professional if signs of serotonin syndrome (mental status changes: agitation, hallucinations, coma; autonomic instability: tachycardia, labile BP, hyperthermia; neuromuscular aberrations: hyperreflexia, incoordination; and/or gastrointestinal symptoms: nausea, vomiting, diarrhea) occur.
  • Advise patient to notify health care professional if pregnancy is planned or suspected, or if breast feeding.

Evaluation/Desired Outcomes

  • Relief of migraine attack.

eletriptan

/el·e·trip·tan/ (el″ĕtrip´tan) a selective serotonin receptor agonist, with actions similar to those of sumatriptan, used as the hydrobromide salt in the treatment of migraine; administered orally

eletriptan

(ĕl′ə-trĭp′tăn)
n.
An oral drug of the triptan class, C22H26N2O2S, used in its hydrobromide form to treat migraine headaches.

eletriptan

an antimigraine agent used for the acute treatment of migraine with or without aura.
References in periodicals archive ?
Eletriptan metabolism by human hepatic CYP450 enzymes and transport by human P-glycoprotein.
Brand names of drugs mentioned in this article Drug Brand name NSAIDs Diclofenac sodium Voltaren (and others) Ketorolac tromethamine Toradol (and others) Mefenamic acid Ponstel (and others) Naproxen sodium Naprelan (and others) Triptans Eletriptan hydrobromide Relpax Frovatriptan succinate Frova Naratriptan hydrochloride Amerge Sumatriptan succinate Imitrex Ergotamines Dihydroergotamine mesylate D.
Almotriptan, eletriptan, rizatriptan, sumatriptan, and zolmitriptan quickly reach peak concentrations in the blood and, therefore, have a faster onset of action.
In the United States, seven triptans indicated for the short-term treatment of migraine with or without aura are available: sumatriptan (Imitrex), almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), and zolmitriptan (Zomig).
Today, there are seven triptans, including sumatriptan (Imitrex), zolmitriptan (Zomig) and eletriptan (Relpax).
Recommended acute therapies for migraine attacks available in the United States NSAIDs * Aspirin * Ibuprofen * Naproxen sodium * Acetaminophen + aspirin + caffeine Opiates/barbiturate hypnotics * Intranasal butorphanol * Other opiates and butalbital-containing compounds may be considered for use as "rescue medications" Ergotamine and derivatives * DHE nasal spray * SC/IM/IV DHE * IV DHE and antiemetic Triptans * Almotriptan (tablets) * Eletriptan (tablets) * Frovatriptan (tablets) * Naratriptan (tablets) * Rizatriptan (tablets, orally disintegrating tablets) * Sumatriptan (tablets, nasal spray, subcutaneous injections, suppositories) * Zolmitriptan (tablets, nasal spray, orally disintegrating tablets) NSAIDs, nonsteroidal anti-inflammatory drugs; DHE, dihydroergotamine.
CHICAGO -- Eletriptan, at both 40 mg and 80 mg dosages, provides superior relief of acute migraine than sumatriptan at 100 mg, according to a poster presentation at the annual meeting of the American Headache Society.
The class of triptans include sumatriptan (imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), naratriptan (Amerge), almotriptan (Axert), eletriptan (Relpax), and frovatriptan (Frova).
32) Seven triptans exist, including almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan.
Systematic reviews of randomized controlled trials (RCTs) summarized that oral sumatriptan (Imitrex), eletriptan (Relpax), and rizatriptan (Maxalt) reduced migraine headache pain and increased the pain-free response rate for adults when compared with placebo.
This study prospectively evaluated efficacy and tolerability of eletriptan early in the attack, while pain was still mild.
CHICAGO -- Eletriptan, at both 40-mg and 80-mg dosages, provides better relief of acute migraine than sumatriptan at 100 mg, according to a poster presentation at the annual meeting of the American Headache Society.