Eletriptan is an acute migraine medication which can be taken to relieve symptoms during a migraine attack. It belongs to a class of medications called triptans.
There are many different treatment options and management strategies available for migraine, so it can be helpful to know what they are before speaking to your doctor or pharmacist. This article will help you better understand eletriptan as one of your treatment options.
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This article is sponsored by Viatris and has been medically reviewed. Last updated July 10, 2024.
What is eletriptan?
Eletriptan is part of a class of medications called ‘triptans’, which belong to a group of drugs called serotonin agonists. Triptans were specifically developed as an acute migraine treatment, targeting the underlying processes that cause symptoms during a migraine attack (1). This sets them apart from other acute treatments such as paracetamol or non-steroidal anti-inflammatory drugs.
Migraine is a complex brain disorder that causes recurrent attacks involving head pain, nausea, and sensitivity to light and/or sound (1). Attacks can last between 4-72 hours and are often disabling.
Eletriptan can be taken to reduce symptoms when you start to experience a migraine attack. Your doctor may recommend trying eletriptan if you do not respond to over-the-counter medications.
Cost and access in Australia
Eletriptan tablets are available in Australia for people who are diagnosed with migraine. It is available over the counter and on prescription.
Since February 2021, lower strengths and quantities of eletriptan have been permitted to be supplied as a schedule 3 (pharmacist-only) medication (2). Patients are now able to purchase 2 x 40mg tablets without a prescription, after speaking to a pharmacist. This is helpful in a number of situations:
- If over-the-counter analgesics alone are inadequate in treating your migraine symptoms;
- While travelling;
- If you run out of medication before your next appointment;
- If you experience migraine very rarely;
- Or any other time that you don’t have your medication with you / aren’t able to access a prescription.
This is a positive step forward for equitable access to migraine medication. These smaller packets are not covered under the PBS and are approximately $10.99 depending on the pharmacy.
Multiple strengths and greater quantities of eletriptan tablets are available on prescription only, which you will need to get from your doctor. These doses and quantities are covered under the PBS, and the cost depends on various factors e.g. patient copayment.
How eletriptan works
Eletriptan belongs to a class of drugs called ‘triptans’, which are acute medications developed specifically to treat migraine pain. However, they aren’t ‘painkillers’ in the same way as paracetamol, ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAIDs).
Triptans target the underlying processes that cause migraine symptoms. In the 1990s, researchers discovered that serotonin played a pivotal role in migraine attacks (1). This led to the development of triptans, which selectively activate the 5-HT1B and 5-HT1D receptors (1). This stops two of the processes that occur during a migraine attack:
- Dilation of blood vessels. Dilated blood vessels contribute towards the pain of a migraine attack. When the 5-HT1B receptor is activated, it helps to constrict (narrow) your blood vessels.
- Activation of trigeminovascular system. The trigeminal nerves usually release proinflammatory proteins during a migraine attack, which causes migraine pain. Activation of the 5-HT1D receptor stops these proinflammatory proteins from being released.
Eletriptan is a highly selective serotonin agonist compared to other triptans. In other words, it activates receptors that help stop proinflammatory substances and blood vessel dilation during a migraine attack. Studies have shown that eletriptan causes the most potent activation in 5-HT1D receptors, and is among the most potent at 5-HT1B receptors (1,3). However, there are many different factors that affect how well you respond to different triptans, so this does not necessarily mean that eletriptan is the best triptan for everyone (4).
Eletriptan is only effective for migraine attacks, and can’t be used to treat other conditions or other headache disorders. Triptans also can’t be used to prevent migraine attacks from occurring.
Dosage and administration
Dosage
Eletriptan is available as tablets in a 40 mg strength over the counter; multiple strengths are available on prescription. The recommended dosing instructions for S3 eletriptan are as follows:
- Take 1 tablet of eletriptan 40 mg.
- Do not take more than 2 tablets (i.e. 80 mg) in one day.
- If you have problems with your kidneys, do not take more than 1 tablet a day.
Prescription eletriptan has different dosing recommendations.
If you take too much eletriptan, you may need urgent medical attention, as this could cause serious heart problems. In this case, you should immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the emergency department at your nearest hospital (5).
Administration
It is generally recommended to take eletriptan as soon as possible after the start of the migraine attack (5). If you experience migraine aura, you should wait until the headache phase begins, as it may be ineffective if taken during the aura phase (6). However, if you aren’t able to take it at the beginning of your attack, it will still provide some relief if taken later (5).
Other important guidelines for when and how to take eletriptan include (5):
- Swallow the tablets whole with a full glass of water, either with or without food.
- Do not take a second dose of eletriptan within 2 hours of taking the first dose.
- If, after initial relief, your migraine comes back, take a second tablet. In this case, wait at least 2 hours between the first tablet and the second.
- If eletriptan does not relieve your migraine, do not take a second dose for the same attack.
- You may take something else for the pain, but do not take medicine containing ergotamine, dihydroergotamine or methysergide for at least 24 hours before or after taking eletriptan.
- Eletriptan will not prevent a migraine attack. If you take it before you get the headache, it will not be effective.
This medication is not available in any other formulations (such as a wafer, nasal spray, or injection). If you experience severe nausea due to the migraine attack and find it difficult to take tablets, you should speak to your doctor about other medication options, or combining eletriptan with an anti-nausea medication.
