Home Drug Guide Eletriptan Hydrobromide

Drug Guide

Generic Name

Eletriptan Hydrobromide

Brand Names Relpax

Classification

Therapeutic: Antimigraine Agent

Pharmacological: Serotonin (5-HT) Receptor Agonist (Triptan)

FDA Approved Indications

  • Acute treatment of migraine with or without aura

Mechanism of Action

Eletriptan is a selective serotonin receptor agonist (5-HT1B/1D), which causes vasoconstriction of cranial blood vessels and inhibits the release of pro-inflammatory neuropeptides, thereby alleviating migraine symptoms.

Dosage and Administration

Adult: Initially 20 mg taken orally, if response inadequate, may be repeated after 2 hours, maximum 80 mg in 24 hours.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; start at lower end of dosing range due to potential increased sensitivity.

Renal Impairment: Adjust dose based on severity; use lower doses in severe impairment.

Hepatic Impairment: Use with caution; start at lower doses and monitor response.

Pharmacokinetics

Absorption: Rapidly absorbed; peak plasma levels in about 1.5 to 2 hours.

Distribution: Widely distributed; high protein binding (~87%).

Metabolism: Primarily hepatic via CYP3A4; minor contributions from CYP2D6.

Excretion: Metabolites excreted mainly in feces and urine.

Half Life: About 4.2 hours.

Contraindications

  • History of ischemic heart disease, coronary artery vasospasm, uncontrolled hypertension, or known hypersensitivity to triptans.

Precautions

  • Use with caution in patients with risk factors for cardiovascular disease; avoid in patients with hemiplegic or basilar migraine; caution in hepatic impairment; assess for contraindications before use.

Adverse Reactions - Common

  • Dizziness (Common)
  • Fatigue (Common)
  • Dry mouth (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Serious coronary artery vasospasm, myocardial infarction, or arrhythmias (Rare)
  • Serotonin syndrome, especially when combined with other serotonergic drugs (Rare)

Drug-Drug Interactions

  • Other serotonergic agents (SSRIs, SNRIs, MAOIs), causing increased risk of serotonin syndrome.
  • Ergot-containing drugs, due to additive vasoconstrictive effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for history of cardiovascular disease, hypertension, or other risk factors before administering.

Diagnoses:

  • Risk for cardiovascular events related to vasoconstriction.

Implementation: Administer orally with or without food; monitor for adverse effects.

Evaluation: Evaluate for relief of migraine symptoms and monitor for adverse reactions.

Patient/Family Teaching

  • Instruct patient to take at first sign of migraine.
  • Advise against use if chest pain or tightness occurs.
  • Warn about possible dizziness, and advise to avoid driving or operating machinery if affected.
  • Discuss the importance of informing healthcare providers about all medications and medical history.

Special Considerations

Black Box Warnings:

  • Coronary artery vasospasm, with potential for myocardial ischemia or infarction

Genetic Factors: CYP3A4 inhibitors can increase eletriptan levels, increasing risk of adverse effects.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Severe vasospasm, chest pain, tightness, arrythmias, or signs of serotonin syndrome.

Treatment: Supportive care; administration of vasodilators such as nitrates if cardiac ischemia suspected; benzodiazepines for agitation or serotonin syndrome.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable until expiration date when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.