Eletriptan

In this section
Does it work?
What is it?
How can it help?
Why should it work?
Can it be harmful?
What's the evidence?

Does it work?

Yes, eletriptan will help if you have a migraine attack. A dose of 40 milligrams (mg) helps 6 in 10 people who take it. Even if your headache is very bad, eletriptan should make it either go away completely or make it much more manageable.

Studies suggest that a dose of 40 mg works best. With a higher dose you have more chance of side effects.

Some research has found that eletriptan works better than a similar drug called sumatriptan.

What is it?

Eletriptan is a type of drug known as a triptan. It works in a way that is similar to a chemical in your brain called serotonin. Like serotonin, eletriptan makes the blood vessels in your brain narrower. This can stop your brain feeling the pain of an attack, at least partly.

The brand name for eletriptan is Relpax.

How can it help?

Eletriptan can make your migraine pain better within two hours.¹

• Your headache should get milder or go away completely.
• All doses give some improvement, but doses of 40 mg and 80 mg work better than doses of 20 mg.
• A 40 mg dose gives you a 6 in 10 chance of your headache getting better in two hours. With an 80 mg dose, your chances are a little better but you run a higher risk of side effects.
• Eletriptan may also help you feel less queasy and help you get back to your normal activities.²
• After taking eletriptan, you have a good chance of your headache not coming back within 24 hours.
• The higher doses of eletriptan work better than sumatriptan.^{1 2 3}

A study looking at all the triptans available at the time (in 2007) found that they all helped to get rid of the pain within two hours, or make it much milder, compared to a dummy drug (a placebo). But only sumatriptan and rizatriptan worked better than a placebo drug within half an hour.⁴

Why should it work?

Like other triptans, eletriptan acts like a chemical in your brain called serotonin. Serotonin is a neurotransmitter, which is a chemical that sends (or 'transmits') signals between nerve cells. Serotonin binds to your cells at specific sites called serotonin receptors, rather like a key being put into a lock.

Eletriptan helps to treat migraine attacks in three main ways.

• When you have an attack, the blood vessels in your brain open up (dilate). This means there is more blood flowing through them. Researchers think this is what causes the pain of attacks. Eletriptan corrects the changes in blood flow and makes the blood vessels narrower.
• It also blocks nerves from releasing chemicals that cause blood vessels in the brain to open up.
• And it blocks the release of chemicals that carry pain messages between different parts of the brain.

All three effects work together to help you feel better.

Can it be harmful?

All triptans can have side effects although they are usually mild and do not last long.¹

• The most common side effects are pins and needles and feelings of warmth in different parts of the body.
• Less common are feeling dizzy or flushed or getting neck pain and stiffness.
• You can get more worrying side effects like feeling confused and drowsy but these are far less common.
• Some people get chest pain or tightness but this is not very common.

Higher doses of eletriptan (40 mg and 80 mg) are more likely to give you side effects than the lowest dose (20 mg). In fact studies show that the lowest dose seems to have no greater risk of side effects than a dummy treatment (a placebo).¹

But it's not clear from the research what proportion of people get side effects. Different studies say different things. And in many studies, people taking a placebo also got side effects.

For example, one large study found that about one-third of people taking eletriptan got side effects, but one-third of people taking a placebo got side effects too.² So it may not always be eletriptan that is causing the side effects.

Here's what other studies have found:

• 7 in 100 people taking 40 mg felt drowsy ⁵
• 3 in 100 to 4 in 100 people taking 40 mg got pins and needles ⁵
• About 5 in 100 people taking 40 mg got dizzy ⁵
• 4 in 100 people taking 40 mg and 5 in 100 taking 80 mg got chest symptoms. (No one taking a placebo got this side effect.)⁶

If you have heart disease, you should not take this medicine. It can make your blood vessels narrower and your heart disease worse. If you have risk factors for heart disease, like high blood pressure, your doctor might want you to take some heart tests before using this medicine to see if it is safe for you.⁷

Triptans and antidepressants

If you take eletriptan (or any other triptan) together with one of the groups of medicines called selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-noradrenaline reuptake inhibitors (SNRIs), there's a chance you could get a condition called serotonin syndrome.⁸ SSRIs and SNRIs are types of antidepressants. They are treatments for depression and some other mental health problems. SNRIs are sometimes called selective serotonin-norepinephrine reuptake inhibitors.

Serotonin syndrome happens when you get too much serotonin in your body. It can be fatal. All SSRIs and SNRIs increase the amount of serotonin in the body. Names (and brand names) of SSRIs and SNRIs include:

• citalopram (Cipramil)
• duloxetine (Cymbalta)
• escitalopram (Cipralex)
• fluovoxamine (Faverin)
• fluoxetine (Prozac)
• paroxetine (Seroxat)
• sertraline (Lustral)
• venlafaxine (Effexor).

The symptoms of serotonin syndrome are:

• Feeling restless
• Rapid changes in blood pressure (you may not notice anything when this happens)
• A rise in your body temperature
• Feeling jittery
• Feeling like you might be sick
• Vomiting
• Diarrhoea.

The chances of getting serotonin syndrome are highest when you start treatment with one of these medicines in addition to one you're already taking, or the dose of one of them is increased.

If you get any of the above symptoms you should see your doctor or go to an emergency department straight away.

What's the evidence?

What's the evidence for eletriptan?