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Indications:

Acute treatment of migraine with or without aura.

Contraindications:

Ischemic heart disease (eg, angina pectoris); symptoms or findings consistent with ischemic heart disease; coronary artery vasospasm (including Prinzmetal variant angina); significant underlying CV disease; cerebrovascular syndromes (including strokes of any type or transient ischemic attacks); peripheral vascular disease (including ischemic bowel disease); uncontrolled hypertension; hemiplegic or basilar migraine; severe hepatic function impairment; hypersensitivity to any component of the product; within 24 h of treatment with another 5-HT 1 agonist or an ergotamine-containing or ergot-type medication (eg, methysergide).

Adverse reactions:

Cardiovascular Palpitation (at least 1%); coronary artery vasospasm; transient myocardial ischemia; MI; ventricular tachycardia; ventricular fibrillation. CNS Dizziness, somnolence (7%); headache (4%); hypertonia, hypesthesia, paresthesia, vertigo (at least 1%). Dermatologic Sweating (at least 1%). GI Nausea (8%); dry mouth (4%); dyspepsia, dysphagia (eg, throat tightness, difficulty swallowing) (2%). Respiratory Pharyngitis (at least 1%). Miscellaneous Asthenia (10%); pain, tightness, or pressure of chest (4%); stomach pain, cramps, or pressure, abdominal pain or discomfort (2%); back pain, chills (at least 1%).

Interactions:

Ergot derivatives (eg, dihydroergotamine) Risk of vasospastic reactions may be increased. Concomitant use within 24 h of eletriptan is not recommended. Other 5-HT 1 agonists Concomitant use of other 5-HT 1 agonists within 24 h of eletriptan is not recommended. Potent CYP-450 3A4 inhibitors (eg, clarithromycin, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, troleandomycin) Eletriptan should not be used within 72 h of drugs that are potent CYP3A4 inhibitors.

Warnings:

Monitor Symptoms of migraine attack Assess pain location, intensity, duration, and associated symptoms of migraine attack and response to treatment. Pregnancy Category C . Lactation Excreted in breast milk. Children Safety and efficacy not established. Elderly There is an increased t ½ (from about 4.4 to 5.7 h) in the elderly (65 to 93 yr of age). CV/Cardiac events It is recommended that eletriptan not be given to patients in whom unrecognized coronary artery disease (CAD) is predicted based on the presence of risk factors (eg, hypertension, hypercholesterolemia, smoker, obesity, diabetes, strong family history of CAD, women with surgical or physiological menopause, men older than 40 yr of age). Serious adverse cardiac events, including MI, life-threatening disturbances of cardiac rhythm, and death have been reported within a few hours of administration of a 5-HT 1 agonist. Cerebrovascular events Cerebral hemorrhage, subarachnoid hemorrhage, stroke, and other cerebrovascular events have been reported with 5-HT 1 agonists. Hypertensive crisis Elevation in BP, including hypertensive crisis, have been reported with administration of 5-HT 1 agonists.

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