Migraine during breastfeeding
Second line
Migraine in nursing mothers when sumatriptan is inadequate. Per AHS 2024 – second-line triptan during breastfeeding. Dose 20-40 mg orally, repeat at 2 h. Max 80 mg/day.
Triptan, selective 5HT1B/1D receptor agonist
ATC code: N02CC06 (Eletriptan)
Brand names
Relpax
Stimulates 5HT1B/1D receptors on dural vessels and trigeminal fibers. Head-to-head trials show the fastest and most durable response among oral triptans (within 30 minutes). CYP3A4 metabolism means levels spike with clarithromycin, ketoconazole, ritonavir – avoid those combinations.
Second line
Migraine in nursing mothers when sumatriptan is inadequate. Per AHS 2024 – second-line triptan during breastfeeding. Dose 20-40 mg orally, repeat at 2 h. Max 80 mg/day.
1 pair found. Sorted from critical to minor.
Mechanism
Eletriptan is a serotonin agonist, CYP3A4 substrate. With phenelzine – fatal serotonin syndrome.
Symptoms
Agitation, tachycardia, hyperthermia, myoclonus, hyperreflexia within hours.
Management
Combination contraindicated. 14 days after MAOI withdrawal before starting triptan.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
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AEMPS Category C. Limited human data; post-marketing registries have not shown a clear increase in major malformations, but exposure samples remain small. SEN recommends paracetamol as first-line for acute migraine in pregnancy; sumatriptan is the best-studied triptan. Eletriptan is considered only for incapacitating attacks unresponsive to better-studied options.
Compatible. Hale L3 (limited data). RID 0.02% – lowest among triptans. Alternative to sumatriptan when response is inadequate.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Eletriptan is evaluated for the following indications with varying evidence strength: Migraine during breastfeeding (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Eletriptan (≥ 1 in 100): Dizziness, Somnolence, Hot flushes, Paraesthesia, Chest or throat tightness (non-ischaemic), Nausea. See the Safety section for uncommon and serious reactions.
FDA category C. AEMPS Category C. Limited human data; post-marketing registries have not shown a clear increase in major malformations, but exposure samples remain small. SEN recommends paracetamol as first-line for acute migraine in pregnancy; sumatriptan is the best-studied triptan. Eletriptan is considered only for incapacitating attacks unresponsive to better-studied options.
Compatible. Hale L3 (limited data). RID 0.02% – lowest among triptans. Alternative to sumatriptan when response is inadequate.
Eletriptan is contraindicated in: Hypersensitivity to triptans or sulfonamides; Ischaemic heart disease, prior myocardial infarction, Prinzmetal angina; Uncontrolled hypertension; Cerebrovascular disease and prior transient ischaemic attack; Peripheral arterial disease. Full list in the Safety section.