Relpax Special Warnings

Frequent Relpax Use and Overuse Headaches

Frequent use of Relpax is generally thought to cause medication-overuse headache, a dull or migraine-like headache that is present at least 15 days per month. Many experts limit Relpax to 2 days per week on a regular basis. If you experience medication-overuse headache you should start preventive treatment.

By keeping a migraine journal of what doses you are taking when you experience a migraine, you can be prepared to discuss if you might be experiencing overuse headaches with your doctor.


Relpax and High Blood Pressure

Relpax has been reported to raise blood pressure in patients with and without high blood pressure. Because Relpax may increase your blood pressure, you should not take Relpax if your blood pressure is uncontrolled.

What is your blood pressure? Keeping a blood pressure log if you have been diagnosed with high blood pressure is a very good way to be prepared to speak with your doctor and be aware of any changes in your condition.

Relpax and Heart Disease

Although extremely rare, serious heart problems, including some that have been fatal, have occurred after taking Relpax. These problems have occurred most often in patients with risk factors for heart disease. Problems included:

  • Coronary artery vasospasm (blood vessels constricting in the heart)
  • Stroke
  • Heart attack
  • Rapid heart rate
  • Irregular heart rate

It is strongly recommended that Relpax not be taken by patients with heart disease risk factors including:

  • High blood pressure
  • High cholesterol
  • Smoker
  • Obesity
  • Diabetes
  • Strong family history of heart disease
  • Menopause
  • Male over 40 years of age

If you have any of these risk factors, have your doctor evaluate your heart and physical condition to determine if you are reasonably free of heart disease and risk of stroke, before taking Relpax.

If you do have risk factors and your doctor decides you can take Relpax, it is strongly recommended that you take your first dose of Relpax in your doctor’s office or a similar setting with medical staff present unless you have previously taken Relpax.

Because stroke can occur your doctor may choose to do an electrocardiogram (ECG) immediately following a dose of Relpax in patients with heart disease risk factors.

What should you do if you experience possible cardiac symptoms while taking Relpax.

If you feel shortness of breath, heart throbbing, persistent pain, tightness or pressure in the chest or throat shortly after taking Relpax, seek immediate medical attention


Relpax and Drugs that Affect Liver Enzymes (CYP3A4 Inhibitors):

Relpax should not be used within at least 72 hours of treatment with the following potent inhibitors of CYP3A4 (an enzyme that helps to break down many compounds in the body):

  • Ketoconazole
  • Itraconazole
  • Nefazodone
  • Troleandomycin
  • Clarithromycin
  • Ritonavir
  • Nelfinavir

Relpax is metabolized primarily by CYP3A4 and inhibitors of this enzyme may change the effect of Relpax.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010.
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