Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C22H26N2O2S.BrH |
Molecular Weight | 463.431 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 1 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
Br.CN1CCC[C@@H]1CC2=CNC3=C2C=C(CCS(=O)(=O)C4=CC=CC=C4)C=C3
InChI
InChIKey=UTINOWOSWSPFLJ-FSRHSHDFSA-N
InChI=1S/C22H26N2O2S.BrH/c1-24-12-5-6-19(24)15-18-16-23-22-10-9-17(14-21(18)22)11-13-27(25,26)20-7-3-2-4-8-20;/h2-4,7-10,14,16,19,23H,5-6,11-13,15H2,1H3;1H/t19-;/m1./s1
DescriptionCurator's Comment: Description was created using several sources including:
https://www.ncbi.nlm.nih.gov/pubmed/10193663 | http://www.migraines.org/treatment/pro_rlpx.htm
Curator's Comment: Description was created using several sources including:
https://www.ncbi.nlm.nih.gov/pubmed/10193663 | http://www.migraines.org/treatment/pro_rlpx.htm
Eletriptan (eletriptan hydrobromide, trade name Relpax) is a selective 5-hydroxytryptamine (5-HT1B/1D) serotonin receptor agonist (triptan) indicated for the acute treatment of migraine with or without aura in adults. Eletriptan binds with high affinity to 5-HT1B, 5-HT1D and 5-HT1F receptors, and has modest affinity for 5-HT1A, 5-HT1E, 5-HT2B and 5-HT7 receptors. The therapeutic activity of eletriptan for the treatment of migraine headache is thought to be due to the agonist effects at the 5-HT1B/1D receptors on intracranial blood vessels (including the arterio-venous anastomoses) and sensory nerves of the trigeminal system which result in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release. Eletriptan (Relpax) has been approved for use in the acute treatment of migraine in 51 countries and has been introduced in 17 countries including Mexico, Italy, France and Japan.
CNS Activity
Sources: https://www.ncbi.nlm.nih.gov/pubmed/11069595
Curator's Comment: Known to be CNS penetrant in rats. Human data not available. It was concluded that eletriptan, acting on perikarya and both the peripheral and the central axon terminals of primary sensory neurons, exerts its antimigraine effect by an agonist action on 5-HT1B/1D receptors throughout the entire trigeminal system, probably by passing the blood-brain-barrier because of its lipophilic character.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: P28221 Gene ID: 3352.0 Gene Symbol: HTR1D Target Organism: Homo sapiens (Human) |
0.92 nM [Kd] | ||
Target ID: P28222 Gene ID: 3351.0 Gene Symbol: HTR1B Target Organism: Homo sapiens (Human) |
3.14 nM [Kd] | ||
Target ID: P30939 Gene ID: 3355.0 Gene Symbol: HTR1F Target Organism: Homo sapiens (Human) |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | RELPAX Approved UseRELPAX is indicated for the acute treatment of migraine with or without aura in adults. RELPAX is not intended for the prophylactic therapy of migraine or for use in the management of hemiplegic or basilar migraine. Safety and effectiveness of RELPAX Tablets have not been established for cluster headache, which is present in an older, predominantly male population. Launch Date2002 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
183.6 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
40 mg 2 times / day multiple, oral dose: 40 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
200.1 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
80 mg single, oral dose: 80 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
46.5 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
94.72 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1278 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
40 mg 2 times / day multiple, oral dose: 40 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
1282 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
80 mg single, oral dose: 80 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
291.3 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
575.6 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
4.75 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
40 mg 2 times / day multiple, oral dose: 40 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
4.58 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
80 mg single, oral dose: 80 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
4.92 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
|
4.63 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/29497279 |
40 mg single, oral dose: 40 mg route of administration: Oral experiment type: SINGLE co-administered: |
ELETRIPTAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
15% |
ELETRIPTAN plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Disc. AE: Nausea, Dizziness... AEs leading to discontinuation/dose reduction: Nausea (0.4%) Sources: Page: Study 102Dizziness (0.4%) Asthenia (0.3%) Chest pain (0.3%) Headache (0.2%) Vomiting (0.2%) Hypertonia (0.2%) Paresthesia (0.2%) Somnolence (0.2%) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Headache | 0.2% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Hypertonia | 0.2% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Paresthesia | 0.2% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Somnolence | 0.2% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Vomiting | 0.2% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Asthenia | 0.3% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Chest pain | 0.3% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Dizziness | 0.4% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Nausea | 0.4% Disc. AE |
80 mg 1 times / day single, oral (typical) Recommended Dose: 80 mg, 1 times / day Route: oral Route: single Dose: 80 mg, 1 times / day Sources: Page: Study 102 |
unhealthy, 41.9 n = 312 Health Status: unhealthy Condition: migraine Age Group: 41.9 Sex: M+F Population Size: 312 Sources: Page: Study 102 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://dmd.aspetjournals.org/content/31/7/861.long Page: 9.0 |
inconclusive | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/21016_Relpax_BioPharmr.pdf#page=9 Page: 9.0 |
major | yes (co-administration study) Comment: when administered with ketoconazole, Cmax and AUC increased by 2.7-fold and 5.9-fold, respectively; when administered with verapamil, Cmax and AUC increased by 2.2-fold and 2.7-fold, respectively; when administered with fluconazole, Cmax and AUC increased by 1.4-fold and 2-fold, respectively; Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/21016_Relpax_BioPharmr.pdf#page=9 Page: 9.0 |
||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/21016_Relpax_BioPharmr.pdf#page=9 Page: 9.0 |
minor | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/21016_Relpax_BioPharmr.pdf#page=9 Page: 9.0 |
minor |
PubMed
Title | Date | PubMed |
---|---|---|
Sumatriptan versus eletriptan: which is best? | 2002 Dec |
|
Current perspectives on effective migraine treatments: are small clinical differences important for patients? | 2003 |
|
Newer formulations of the triptans: advances in migraine management. | 2003 |
|
[Strong and sustained-acting triptan. Therewith migraine does not return soon]. | 2003 Aug 7 |
|
Comparative efficacy of eletriptan and zolmitriptan in the acute treatment of migraine. | 2003 Dec |
|
[Treatment of migraine: an update]. | 2003 Jan |
|
[Pharmacological, pharmacokinetic and clinical profile of eletriptan (Relpax), a new triptan for migraine]. | 2003 Jul |
|
Eletriptan issues. | 2003 Jul-Aug |
|
A cost-effectiveness analysis of eletriptan 40 and 80 mg versus sumatriptan 50 and 100 mg in the acute treatment of migraine. | 2003 Jul-Aug |
|
Cost-effectiveness of migraine treatment: a commentary. | 2003 Jul-Aug |
|
The evolving management of migraine. | 2003 Jun |
|
Safety profile of the triptans. | 2003 Mar |
|
Efficacy, safety, and tolerability of oral eletriptan for treatment of acute migraine: a multicenter, double-blind, placebo-controlled study conducted in the United States. | 2003 Mar |
|
[Highly selective beginning. Associated symptoms and side effects in retrospect]. | 2003 May 26 |
|
[Improved pharmacokinetics. Fast tryptan with sustained response]. | 2003 May 26 |
|
Comparative efficacy of eletriptan vs. naratriptan in the acute treatment of migraine. | 2003 Nov |
|
Efficacy of eletriptan in migraineurs with persistent poor response to nonsteroidal anti-inflammatory drugs. | 2003 Oct |
|
Tolerability and safety of eletriptan in the treatment of migraine: a comprehensive review. | 2003 Oct |
|
Musing on Mathew et al. | 2003 Sep |
|
Encapsulated sumatriptan is not bioequivalent to commercial sumatriptan. | 2003 Sep |
|
Unilateral time-delayed encapsulation does not make for a fair race. | 2003 Sep |
|
Migraine: diagnosis and management. | 2003 Sep-Oct |
|
Eletriptan for the short-term prophylaxis of cluster headache. | 2004 Apr |
|
Meta-analysis of oral triptans. | 2004 Aug |
|
New drugs 04, part 1. | 2004 Feb |
|
The 40-mg dose of eletriptan: comparative efficacy and tolerability versus sumatriptan 100 mg. | 2004 Feb |
|
[Use of triptanes according to indications. Risk of infarct is not increased]. | 2004 Feb 12 |
|
The 5-hydroxytryptamine1B/1D/1F receptor agonists eletriptan and naratriptan inhibit trigeminovascular input to the nucleus tractus solitarius in the cat. | 2004 Feb 13 |
|
Neuronal expression and regulation of CGRP promoter activity following viral gene transfer into cultured trigeminal ganglia neurons. | 2004 Jan 30 |
|
Gateways to clinical trials. | 2004 Jan-Feb |
|
Effect of high-dose intravenous eletriptan on coronary artery diameter. | 2004 Jul |
|
Cardiovascular safety of triptans. | 2004 Jul |
|
Involvement of 5-HT1B receptors in triptan-induced contractile responses in guinea-pig isolated iliac artery. | 2004 Jul |
|
Nitrergic and glutamatergic neuronal mechanisms at the trigeminovascular first-order synapse. | 2004 Jul |
|
Gateways to clinical trials. | 2004 Jul-Aug |
|
Triptans and CNS side-effects: pharmacokinetic and metabolic mechanisms. | 2004 Jun |
|
Gateways to clinical trials. | 2004 Mar |
|
Eletriptan for the acute treatment of migraine: results of bridging a Japanese study to Western clinical trials. | 2004 Mar |
|
Cost considerations of acute migraine treatment. | 2004 Mar |
|
Cost effectiveness of oral triptan therapy: a trans-national comparison based on a meta-analysis of randomised controlled trials. | 2004 May |
|
Double-blind clinical trials of oral triptans vs other classes of acute migraine medication - a review. | 2004 May |
|
[A case of the usefulness of MR angiography and diffusion weighted image to evaluate migraine]. | 2004 Oct |
|
[Spanish contribution to the clinical development of eletriptan: an analysis of controlled studies]. | 2004 Oct |
|
No effect of eletriptan administration during the aura phase of migraine. | 2004 Oct |
|
[Meta-analysis of triptan treatment in migraine]. | 2004 Sep |
|
[Triptans in migraine: from clinical view]. | 2004 Sep |
|
[Triptans in migraine: a comparative review of pharmacology, pharmacokinetics]. | 2004 Sep |
|
Gateways to clinical trials. | 2004 Sep |
|
Priorities for triptan treatment attributes and the implications for selecting an oral triptan for acute migraine: a study of US primary care physicians (the TRIPSTAR Project). | 2004 Sep |
|
TRIPSTAR: prioritizing oral triptan treatment attributes in migraine management. | 2004 Sep |
Sample Use Guides
The maximum recommended single dose of Relpax (eletriptan hydrobromide) is 40 mg. If after the initial dose, headache improves but then returns, a repeat dose may be beneficial. If a second dose is required, it should be taken at least 2 hours after the initial dose. If the initial dose is ineffective, controlled clinical trials have not shown a benefit
of a second dose to treat the same attack. The maximum daily dose should not exceed 80 mg.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/15185063
The 5-hydroxytryptamine (5-HT) receptor mediation of the contraction in guinea-pig iliac arteries moderately precontracted by prostaglandin F2alpha (PGF2alpha) was characterized in vitro using eletriptan. Eletriptan contracted guinea-pig iliac arteries and the concentration-response curve for eletriptan was biphasic (first phase: 0.01-3 uM, pD2 approximately 6.6; second phase: greater or equal 10 uM).
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NCI_THESAURUS |
C47794
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SUB26382
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m4867
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M41W832TA3
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C47508
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DBSALT000884
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ACTIVE MOIETY
SUBSTANCE RECORD