eletriptan hydrobromide: clinical use

Prescribing considerations

• Confirm a clear migraine diagnosis; do not use for atypical headache or prophylaxis.
• Assess cardiovascular risk where unrecognised coronary disease is plausible.
• Review frequent or daily headache for possible medication-overuse headache.
• Consider renal and hepatic function, age, pregnancy, breastfeeding and interacting medicines.
• Warn about dizziness or somnolence affecting driving and machinery use.

Contraindications and cautions

• Severe renal or hepatic impairment
• Moderate-to-severe hypertension or untreated mild hypertension
• Ischaemic heart disease, coronary vasospasm, significant arrhythmia or heart failure
• Peripheral vascular disease
• Previous stroke or transient ischaemic attack
• Concurrent other triptan use or use too close to ergot derivatives
• Hypersensitivity to eletriptan or an excipient

Monitoring

• Assess new or intense chest symptoms promptly and stop further use pending evaluation if cardiac ischaemia is suspected.
• Monitor clinically for serotonin syndrome when combined with SSRIs, SNRIs or other serotonergic medicines.
• Review blood pressure and headache frequency where clinically appropriate.
• No routine laboratory-monitoring programme is specified in the product information.

Clinical pharmacology

Eletriptan is a selective vascular 5-HT1B and neuronal 5-HT1D receptor agonist, with affinity for 5-HT1F receptors. It is absorbed orally, metabolised mainly through CYP3A4 and eliminated predominantly by metabolism, with a plasma half-life of approximately four hours.

Formulation and product differences

• The selected product is an orange, round film-coated oral tablet intended to be swallowed whole.
• It contains lactose and Sunset Yellow FCF, which may cause allergic reactions; it is essentially sodium-free.
• No non-oral eletriptan formulation is represented by the selected product.

Tablet

Route: Oral

Strengths: 20 mg, 40 mg