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Relpax® (Eletriptan Hydrobromide)

Editorial note: On, August 16, 2019, “Pfizer Inc. is voluntarily recalling RELPAX® (eletriptan hydrobromide) 40 mg tablets, lots AR5407, and CD4565, to the Patient level. Pfizer Inc. initiated this recall because these product lots may not meet Pfizer’s in-house microbiological specification for the potential presence of Genus Pseudomonas and Burkholderia. Individuals who consume oral products contaminated with microorganisms are at risk of bacterial dissemination from the gut to the bloodstream potentially resulting in serious, life-threatening infections. In addition, there is a risk of temporary gastrointestinal distress without serious infection…” For the full FDA announcement, read here.

Relpax® (eletriptan hydrobromide) is a selective 5-HT1B/1D receptor agonist (triptan) indicated for the acute treatment of migraine, with or without aura, in adults who have a clear migraine diagnosis. It comes in tablet form and is administered by mouth.

Relpax generally begins to work within 2 hours. It is intended to reduce acute symptoms of migraine attacks that have already begun. It should not to be used as a prophylactic therapy to prevent the onset of migraine or to treat hemiplegic or basilar migraine.

Overuse of acute migraine drugs can cause medication overuse headaches. Overuse is considered dosing more than 3 days per month. Symptoms of overuse may need to be treated separately, and detoxification from migraine medications may be required.

What are the ingredients in Relpax?

The active ingredient in Relpax is eletriptan hydrobromide.

How does Relpax work?

Relpax works by binding with 5-HT1B/1D receptors on blood vessels in the brain. It narrows the blood vessels (constriction) surrounding the brain, which is correlated with the relief of migraine. It also reduces inflammatory substances in the body that can trigger head pain, nausea, sensitivity to light and sound, and other migraine symptoms. Relpax works best if it is taken as soon as migraine symptoms appear.

What are the possible side effects of Relpax?

Many clinical trials evaluated the safety and efficacy of Relpax. The most common side effects experienced by those taking Relpax include:

  • Dizziness
  • Nausea
  • Pain or tight feeling in the chest, throat, jaw, or neck
  • Fatigue, i.e. feeling weak, drowsy, or tired

This is not an exhaustive list of all potential side effects of Relpax. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Relpax, contact your doctor or healthcare provider immediately.

Things to note about Relpax

Relpax come in 2 strengths, 20 mg and 40 mg. Before starting Relpax talk with your doctor if you:

  • Have a history of hypersensitivity to eletriptan hydrobromide
  • Have a history of coronary artery disease (CAD), angina or heart attacks
  • Have a history of high blood pressure or high cholesterol
  • Have a history of hemiplegic or basilar migraine
  • Have a history of stroke, transient ischemic attacks (TIAs)
  • Have a history of peripheral vascular disease (circulation problems)
  • Have a history of ischemic bowel disease
  • Have taken an ergot-containing medication or other triptans within the 24 hours prior to migraine
  • Have taken a CYP3A4 inhibitors within 72 hours of treatment
  • Have taken an MAO-A inhibitor within 2 weeks prior to migraine onset
  • Take propranolol
  • Take anti-depressant medicines, including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs)
  • Have severe hepatic (liver) impairment
  • Have severe renal (kidney) problems
  • Are pregnant or planning to get pregnant, as there is limited information on the use of Relpax in pregnancy. It should be used only if the potential benefit of Relpax therapy exceeds risk to the fetus.

Individuals with the above conditions should be monitored closely while taking Relpax.

If there is no response to the first migraine attack treated with the Relpax, a physician should reconsider the migraine diagnosis prior to using the medication in any subsequent attacks.

A cardiovascular evaluation should be performed on patients who have never taken a triptan medication but who have multiple cardiovascular risk factors (e.g., increased age, diabetes, hypertension, smoking, obesity, strong family history of CAD) before starting Relpax. For those with a cardiac history, the first dose of Relpax should be administered in a medically supervised setting and an electrocardiogram (ECG) should be performed immediately following the dose.

Dosing information

Relpax tablets are taken by mouth with water or other liquids. They come in 2 strengths; 20 mg and 40 mg. Studies have shown the most effective dose is generally 40 mg. If only partial migraine relief is attained or symptoms return quickly, a second dose may be taken 2 hours after the first. The maximum adult dose in a 24-hour period is 2 tablets or 80 mg. A physician will determine the appropriate dose for each patient.

Before taking Relpax make sure to tell your doctor about all the medicines you take, including prescription and nonprescription, vitamins, and herbal supplements. Relpax and other medicines may affect each other, causing side effects. Because Relpax can cause dizziness, weakness, or drowsiness, do not drive a car, use machinery, or do anything requiring you to be fully alert when taking this medication. Keep track of when you have migraine attacks and when you take Relpax, so you can monitor the effectiveness and communicate with your doctor about how the medication is working for you.

For additional details, read the full prescribing information of Relpax.

Written by: Linda Saxl Minton | Last reviewed: August 2019
  1. RELPAX prescribing information available at: Accessed 4/28/18.