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Triptan (5-HT₁B/1D agonist) Pregnancy: Not stated in source

Eletriptan

Brand names: Relpax

Eletriptan is a triptan (5-HT1B/1D receptor agonist) used for the acute treatment of migraine attacks with or without aura.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 20 mg or 40 mg
Route: Oral
Frequency: Single dose for acute migraine attack; if migraine has not resolved by 2 hours or returns after transient improvement, a second dose may be taken at least 2 hours after the first
Max: Maximum single dose 40 mg; maximum daily dose 80 mg
US labelling. For acute treatment of migraine in adults. A greater proportion of patients respond to 40 mg than 20 mg. Safety of treating an average of more than 3 migraine attacks in a 30-day period has not been established. Must not be used within at least 72 hours of potent CYP3A4 inhibitors, or within 24 hours of another 5-HT1 agonist or ergotamine/ergot-type medication.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Ischaemic coronary artery disease (angina, prior MI, documented silent ischaemia) or coronary artery vasospasm including Prinzmetal's angina
  • Wolff-Parkinson-White syndrome or arrhythmias with other cardiac accessory conduction pathway disorders
  • History of stroke or TIA, or hemiplegic or basilar migraine
  • Peripheral vascular disease; ischaemic bowel disease
  • Uncontrolled hypertension
  • Recent use (within 24 hours) of another 5-HT1 agonist, ergotamine-containing or ergot-type medication (e.g. dihydroergotamine, methysergide)
  • Recent use (within at least 72 hours) of potent CYP3A4 inhibitors (ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir)
  • Hypersensitivity to eletriptan (angioedema and anaphylaxis seen)

Side effects

  • Asthenia
  • Nausea
  • Dizziness
  • Somnolence
  • Chest/throat/neck/jaw pain, tightness or pressure

Interactions

  • Ergotamine-containing/ergot-type medications and other 5-HT1 agonists: use within 24 hours contraindicated (additive prolonged vasospastic reactions)
  • Potent CYP3A4 inhibitors: significantly increase eletriptan exposure; do not use within at least 72 hours
  • SSRIs/SNRIs/TCAs/MAO inhibitors: cases of serotonin syndrome reported with co-administration of triptans

Clinical monograph

How it works

It stimulates 5-HT1B and 5-HT1D receptors, causing cranial vasoconstriction and inhibiting the release of pro-inflammatory neuropeptides involved in migraine pain.

Prescribing in practice

  • Avoid in ischaemic heart disease, uncontrolled hypertension, and cerebrovascular or peripheral vascular disease because of the risk of vasospasm.
  • Do not combine with ergotamine-type medicines or other triptans within a short interval owing to additive vasoconstriction.
  • Frequent use can lead to medication-overuse headache.

Monitoring

Monitor migraine response, frequency of use to detect medication-overuse headache, and cardiovascular risk factors before and during use.

Counselling the patient

  • Take at the onset of migraine headache rather than during aura alone.
  • Limit the number of treatment days per month to avoid medication-overuse headache.
  • Report any chest tightness, pressure or pain after taking it.

Evidence & guidelines

Triptans, including eletriptan, are recommended by NICE for acute migraine and are supported by randomised controlled trials.

Reference: NICE NG150; BASH; ABN migraine guidance; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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