Relpax is a brand-name prescription medication that’s used to treat migraine with or without aura.

Migraine is a neurological condition that can include a severe headache that may last for hours, sensitivity to light, nausea, and vomiting. An aura is a sensation you may have around the time a migraine starts. Auras can include seeing flashes of light or feeling tingling in your hands or feet.

Relpax is approved for use in adults who have been diagnosed with migraine. The drug isn’t used to help prevent migraine. Relpax also isn’t used to treat cluster headaches.

Relpax contains the drug eletriptan, which is an antimigraine medication. Specifically, it belongs to a class of drugs known as triptans. (A class of drugs is a group of medications that work in a similar way.) Triptans narrow swollen blood vessels in your brain, which may lead to less pain.

Relpax comes as a tablet that you swallow. It’s available in two strengths: 20 mg and 40 mg. You take Relpax when you have migraine, and if your symptoms don’t ease after 2 hours, you can take a second dose.

Effectiveness

Relpax was shown to be an effective medication to treat migraine in clinical trials. Between 53.9% and 65% of people who took 40 mg of Relpax had a mild headache or no headache 2 hours after their dose.

In comparison, between 19% and 39.5% of people who took a placebo (treatment with no active drug) had a mild headache or no headache 2 hours after their dose.

Relpax can quickly and effectively ease migraine symptoms in people with the condition.

Relpax is available as a brand-name medication and as a generic form. The generic form is called eletriptan.

A generic drug is an exact copy of a brand-name medication. Generics tend to cost less than brand-name drugs.

Relpax contains the active drug eletriptan. (As the active drug, eletriptan is the ingredient that makes Relpax work.)

Relpax can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Relpax. These lists don’t include all possible side effects.

For more information on the possible side effects of Relpax, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you’d like to report to the FDA a side effect you’ve had with Relpax, you can do so through MedWatch.

More common side effects

The more common side effects of Relpax can include:

  • nausea
  • feeling weak or like you have no energy
  • dizziness
  • sleepiness
  • tightness, pain, or pressure in your chest, throat, neck, or jaw

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Relpax aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Serious heart problems, such as a heart attack. Symptoms can include:
    • tightness, pressure, or pain in your chest
    • trouble breathing
    • feeling dizzy or lightheaded
  • Heart rhythm changes. Symptoms can include:
    • feeling dizzy
    • palpitations (feeling of skipped or extra heartbeats)
    • chest pain
    • fainting
  • Bleeding in the brain or stroke. Symptoms can include:
    • sudden numbness or weakness on one side of your body
    • feeling confused
    • trouble walking
    • severe headache that occurs suddenly
  • Problems with blood circulation, such as Raynaud’s syndrome (lack of blood flow to your nose, ears, fingers, or toes). Symptoms can include:
    • blue fingers or toes
    • numb feeling in your fingers or toes
    • numbness or weakness in your legs
    • cramping or pain in your legs
  • Stomach or intestine problems. Symptoms can include:
  • Serotonin syndrome (high levels of the chemical serotonin). Symptoms can include:
    • sweating
    • fast heart rate
    • blood pressure changes
    • feeling agitated or restless
    • hearing or seeing things that aren’t there
    • lack of coordination
  • High blood pressure. Symptoms can include:
    • severe headache
    • chest pain
    • feeling confused
    • pounding sound in your ears or pounding feeling in your chest
    • irregular heartbeat (heartbeat that’s too fast, too slow, or uneven)
  • Medication overuse headache (from taking too much Relpax or using it too often). Symptoms can include:
    • migraine headaches every day or more often than usual

Other serious side effects, explained in more detail below in “Side effect details,” include:

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on a few of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Relpax. It’s not known how many people in clinical trials had an allergic reaction to Relpax. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Relpax. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Nausea

Nausea can occur with Relpax use. Nausea was reported as one of the most common side effects of Relpax in clinical trials, affecting 5% of people who took 40 mg of Relpax. (The highest strength of Relpax is 40 mg.) However, nausea also affected 5% of people who took a placebo (treatment with no active drug). That’s because nausea is a common symptom of migraine headaches.

Clinical trials also studied 80-mg doses of Relpax. About 8% of people who took 80 mg of Relpax had nausea as a side effect. This was compared with 5% of people who took a placebo. Therefore, it’s possible that the medication may cause nausea with higher doses.

If you do have nausea as a side effect of taking Relpax, talk with your doctor. They may be able to suggest ways to help you feel more comfortable.

The Relpax dosage your doctor prescribes will depend on several factors. These include:

  • the severity of the condition you’re using Relpax to treat
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Relpax comes as a tablet that you swallow. It’s available in two strengths: 20 mg and 40 mg.

Dosage for migraine

To treat current migraine, your doctor may recommend a dose of either 20 mg or 40 mg. You should never take more than 40 mg of Relpax at one time. If your migraine doesn’t go away after 2 hours, you can take another dose of Relpax. The maximum amount of Relpax that you can take in 1 day is 80 mg (separated into two doses).

Relpax hasn’t been studied to treat more than three migraine headaches in 30 days. It’s not known if the medication is safe when it’s used more often than this.

What if I miss a dose?

Relpax is a medication that you take only if you have migraine. Relpax doesn’t work to prevent migraine, so you shouldn’t take it every day. You can take a second dose of Relpax if you still have migraine after 2 hours.

Will I need to use this drug long term?

Relpax isn’t meant to be used as a long-term treatment. If you and your doctor find that the medication works for you, you’ll use it only when you get migraine. The safety and effectiveness of Relpax hasn’t been tested on more than an average of three migraine headaches per month.

If you find yourself taking Relpax on a regular basis, talk with your doctor about ways to help prevent migraine.

The Food and Drug Administration (FDA) approves prescription drugs such as Relpax to treat certain conditions.

The only condition that Relpax is approved to treat is migraine. Migraine is a neurological condition that often includes a severe headache that may last from 4 to 72 hours. Other symptoms of migraine can include vision problems (such as seeing stars, blurry vision, or blind spots), sensitivity to light, nausea, and vomiting.

Migraine can be very severe and affect your daily activities, making it hard to go to work or school. And migraine may have a genetic link. This means that if someone in your family has migraine, you’re more likely to have it, too. Migraine may be due to blood vessels in your brain getting too wide. However, research hasn’t yet found a definite cause of migraine.

Relpax can be used to treat current migraine with or without aura. Aura is a change in your senses that occurs right before or at the same time as migraine. These changes include seeing flashes of light or zig-zag lines that shimmer, or feeling tingling in your hands or feet.

Relpax is approved for use in adults who have been diagnosed with migraine. The drug isn’t used to help prevent migraine. Relpax also isn’t used to treat cluster headaches.

Effectiveness

Relpax was shown to be an effective medication to treat migraine in clinical trials. Between 53.9% and 65% of people who took 40 mg of Relpax had a mild headache or no headache 2 hours after their dose.

In comparison, between 19% and 39.5% of people who took a placebo (treatment with no active drug) had a mild headache or no headache 2 hours after their dose. Relpax can quickly and effectively ease migraine symptoms in people with the condition.

Relpax for other conditions

In addition to the use listed above, you may wonder if Relpax is used for certain other conditions.

Relpax for headaches (not an appropriate use)

Relpax shouldn’t be used to treat headaches, which are defined as pain that occurs in your head or neck. Unlike those who have migraine, people with headaches don’t usually have other symptoms besides head or neck pain. Headaches can be caused by many different factors, including stress, allergies, dehydration, and high blood pressure.

In comparison, migraine can include severe head pain that affects your daily life, making it hard to go to work or school. Migraine may also cause other symptoms such as nausea, vomiting, vision problems (for example, blurry vision, blind spots, or seeing stars), and sensitivity to light.

If you have headaches on a regular basis, talk with your doctor. They can help you figure out possible causes and suggest treatment.

Relpax for cluster headaches (not an appropriate use)

Relpax shouldn’t be used to treat cluster headaches. People who have cluster headaches have multiple severe headaches over a “cluster” period of weeks to months. Then they may not have any headaches for months or years later.

It’s not known if Relpax is a safe and effective medication to be used in the treatment of cluster headaches. Part of the reason that Relpax hasn’t yet been studied in treating cluster headaches is due to how long the drug takes to work. Cluster headaches usually last only 30 to 45 minutes but can last for a few hours. Relpax may take up to 2 hours to have its full effect, and by that time, your cluster headache may be gone.

Relpax won’t work to prevent future cluster headaches.

Relpax and children

Although Relpax isn’t approved for use in children, a clinical trial was done in children ages 11 to 17 years. This study didn’t show that Relpax was effective in these children. In the study, 57% of children ages 11 through 17 years reported a mild headache or no headache after 2 hours, whether they took 40 mg of Relpax or a placebo.

More studies are needed to determine if Relpax is a safe and effective medication for migraine in children.

Other drugs are available that can treat migraine. Some may be a better fit for you than others. If you’re interested in finding an alternative to Relpax, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for migraine

Examples of other drugs that may be used to treat migraine include:

  • Other triptan medications, such as:
    • frovatriptan (Frova)
    • rizatriptan (Maxalt)
    • sumatriptan (Imitrex)
    • zolmitriptan (Zomig)
    • almotriptan (Axert)
    • sumatriptan/naproxen sodium (Treximet)
    • naratriptan (Amerge)
  • Ergot drugs, such as:
    • dihydroergotamine (Migranal)
    • bromocriptine (Parlodel)
    • ergotamine tartrate (Ergomar)
    • ergotamine/caffeine (Cafergot)
  • Anti-inflammatory medications, such as:
  • Pain medications, such as:
    • acetaminophen/aspirin/caffeine (Excedrin Migraine)
    • acetaminophen (Tylenol)
    • bultalbital/acetaminophen/caffeine (Fioricet)
    • bultalbital/aspirin/caffeine (Fiorinal)

You may wonder how Relpax compares with other medications that are prescribed for similar uses. Here we look at how Relpax and Imitrex are alike and different.

Ingredients

Relpax contains the drug eletriptan. Imitrex contains the drug sumatriptan.

Uses

Relpax is approved to treat migraine with or without aura in adults. You should use this drug only if you have a diagnosis of migraine. Relpax shouldn’t be used to prevent migraine or treat cluster headaches.

Imitrex is also approved to treat migraine with or without aura in adults. In addition, the forms of Imitrex that are given as injections can be used to treat cluster headaches. Imitrex shouldn’t be used to prevent migraine or cluster headaches.

Drug forms and administration

Here’s some information about the forms of each drug and how you take them.

Relpax form

Relpax comes as a tablet that you take by mouth when you have migraine. If you take one tablet of Relpax and still have migraine symptoms 2 hours later, you can take a second tablet.

Imitrex forms

Imitrex is available in four forms. One form is a tablet that you take by mouth when you have migraine. Like Relpax, if you still have migraine 2 hours after your first dose of Imitrex, you can take one more dose.

The other forms of Imitrex are:

  • a nasal spray
  • a single-dose vial of liquid solution that you use with a syringe
  • a single-dose prefilled syringe cartridge that you use with an Imitrex STATdose pen

These forms may work faster than the tablets, but they may have additional side effects. The side effects may include a bad taste or burning sensation from the nasal spray and injection site reactions from using a syringe or STATdose pen.

Side effects and risks

Relpax and Imitrex are both a type of drug called a triptan, which is used to treat migraine. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Relpax, with Imitrex, or with both drugs (when taken individually).

  • Can occur with Relpax:
    • nausea
    • feeling weak or like you have no energy
    • sleepiness
  • Can occur with Imitrex:
    • feeling warm or cold
    • tingling feeling in your hands, arms, legs, or feet
    • feeling uncomfortable or worn out
  • Can occur with both Relpax and Imitrex:
    • tightness, pain, or pressure in your chest, throat, neck, or jaw
    • dizziness

Serious side effects

These lists contain examples of serious side effects that can occur with Relpax, with Imitrex, or with both drugs (when taken individually).

Effectiveness

The only condition both Relpax and Imitrex are used to treat is migraine with or without aura.

The use of Relpax and Imitrex in treating migraine has been directly compared in a clinical study. Researchers compared Relpax with Imitrex and a placebo (treatment with no active drug). Here are the percentages of people who had a mild headache or no headache 2 hours after the dose:

  • 67% of people who took 40 mg of Relpax
  • 59% of people who took 100 mg of Imitrex
  • 26% of people who took a placebo

Relpax was also more effective than Imitrex at easing nausea and sensitivity to light, and getting people back to their usual activities.

Costs

Relpax and Imitrex are both brand-name drugs. There are currently generic forms of both drugs. (A generic drug is an exact copy of a brand-name medication.) Brand-name medications usually cost more than generics.

Brand-name Relpax tablets cost significantly less than brand-name Imitrex tablets. But generic Relpax tablets cost significantly more than generic Imitrex tablets. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Like Imitrex (above), the drug Maxalt has uses similar to those of Relpax. Here’s a comparison of how Relpax and Maxalt are alike and different.

Ingredients

Relpax contains the drug eletriptan. Maxalt contains the drug rizatriptan.

Uses

Both Relpax and Maxalt are medications that are used to treat migraine with or without aura in adults. You should use these drugs only if you have a diagnosis of migraine. Neither Relpax nor Maxalt should be used to prevent migraine or treat cluster headaches. And these medications shouldn’t be used to treat hemiplegic migraine or basilar migraine.

Unlike Relpax, Maxalt is also approved for use in children ages 6 to 17 years.

Drug forms and administration

Here’s some information about the forms of each drug and how you take them.

Relpax form

Relpax comes as a tablet that you take by mouth when you have migraine. If you take one tablet of Relpax and still have migraine symptoms 2 hours later, you can take a second tablet.

Maxalt forms

Maxalt is available in two forms. One form is a tablet that you swallow.

The second form is an orally disintegrating tablet called Maxalt-MLT. The tablet dissolves on your tongue, and you don’t need any water to take it.

Adults and children should take Maxalt when they have migraine. Adults can repeat the dose 2 hours after their first dose if they still have migraine. Children shouldn’t take more than one dose of Maxalt in 24 hours.

Side effects and risks

Relpax and Maxalt are both a type of drug called a triptan, which is used to treat migraine. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Relpax, with Maxalt, or with both drugs (when taken individually).

  • Can occur with Relpax:
  • Can occur with Maxalt:
    • few unique common side effects
  • Can occur with both Relpax and Maxalt:
    • feeling weak or like you have no energy
    • sleepiness
    • dizziness
    • tightness, pain, or pressure in your chest, throat, neck, or jaw

Serious side effects

This list contains examples of serious side effects that can occur with both Relpax and Maxalt (when taken individually):

Effectiveness

The only condition both Relpax and Maxalt are used to treat is migraine with or without aura in adults.

These drugs haven’t been directly compared in clinical studies, but studies have found both Relpax and Maxalt to be effective for treating migraine with or without aura.

Costs

Relpax and Maxalt are both brand-name drugs. There are currently generic forms of both drugs. (A generic drug is an exact copy of a brand-name medication.) Brand-name medications usually cost more than generics.

Brand-name and generic Relpax tablets cost significantly more than brand-name and generic Maxalt tablets. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Relpax can interact with several other medications. It’s not known to interact with supplements or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Relpax and other medications

Below is a list of medications that can interact with Relpax. This list doesn’t contain all drugs that may interact with Relpax.

Before taking Relpax, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Relpax and other triptan medications

Relpax is a type of drug called a triptan. It works by narrowing blood vessels in your head. Taking more than one triptan medication can increase your risk of side effects, such as heart attack or serotonin syndrome (high levels of the chemical serotonin). (For more about side effects, see the “Relpax side effects” section above.)

You should never take Relpax with other triptan medications. And you shouldn’t use Relpax within 24 hours of taking another triptan medication. This is because triptans may still be in your body for 24 hours after you take your dose.

Examples of other triptan drugs to avoid while taking Relpax include:

  • frovatriptan (Frova)
  • rizatriptan (Maxalt)
  • sumatriptan (Imitrex)
  • zolmitriptan (Zomig)
  • almotriptan (Axert)
  • sumatriptan/naproxen sodium (Treximet)
  • naratriptan (Amerge)

If you’re taking one of these drugs, talk with your doctor before you start to use Relpax. They can review your treatment plan and suggest the best medication for you.

Relpax and ergot drugs

Like Relpax, medications that contain ergot work by narrowing blood vessels in your head. So taking Relpax with an ergot drug can increase your risk for side effects. These side effects include heart attack or stroke. (For more about side effects, see the “Relpax side effects” section above.)

You should never take Relpax with drugs that contain ergot. And you shouldn’t use Relpax within 24 hours of taking these medications. This is because ergot drugs may still be in your body for 24 hours after you take your dose.

Examples of ergot drugs to avoid while taking Relpax are:

  • dihydroergotamine (Migranal)
  • belladonna/ergotamine/phenobarbital (Bellergal-S)
  • ergotamine tartrate (Ergomar)
  • ergotamine/caffeine (Cafergot)

If you’re taking one of these drugs, talk with your doctor before you start to use Relpax. They can review your treatment plan and suggest the best medication for you.

Relpax and medications that affect your serotonin levels

Relpax increases the level of a chemical in your brain called serotonin, which helps regulate your mood. Many anxiety or depression medications may increase the level of serotonin. Taking Relpax along with other medications that can increase the level of serotonin may cause a dangerous condition called serotonin syndrome.

Serotonin syndrome can occur when you have too much serotonin in your body. Symptoms can include a lack of coordination, feeling agitated or restless, sweating, or a fast heart rate. Serotonin syndrome can also lead to hearing or seeing things that aren’t there or changes in blood pressure.

In addition, you should never take Relpax within 72 hours of taking nefazodone. Using these two medications within 72 hours of each other can increase the level of Relpax in your body. This can then lead to very serious side effects such as serotonin syndrome.

Examples of medications that affect your serotonin levels include:

If you need to take more than one medication that affects your serotonin level, your doctor may monitor you more often for signs of serotonin syndrome. They may also adjust the dosage of your medications.

Relpax and certain antifungal medications

You shouldn’t take Relpax while you’re using certain antifungal medications. If you’re taking either itraconazole (Sporanox) or ketoconazole (Nizoral), you shouldn’t use Relpax within 72 hours. This is because the combination of these medications can raise the level of Relpax in your body. And too much Relpax may increase your risk for serious side effects such as higher blood pressure or heart attack. (For more about side effects, see the “Relpax side effects” section above.)

If you’re taking Relpax, it’s very important to talk with your doctor before you start using any antifungal medications.

Relpax and clarithromycin

You should never take Relpax within 72 hours of using clarithromycin (Biaxin). This is an antibiotic that may be used to treat certain bacterial infections. Using clarithromycin along with Relpax may cause your level of Relpax to become too high. This can lead to serious side effects such as heart problems, which can include high blood pressure or heart attack. (For more about side effects, see the “Relpax side effects” section above.)

If you’re taking Relpax, it’s very important to talk with your doctor before you start using clarithromycin.

Relpax and certain antiviral medications

Certain antiviral medications can interact with Relpax. If you’re taking either ritonavir (Norvir) or nelfinavir (Viracept), you shouldn’t use Relpax within 72 hours of taking these medications. This is because taking these medications together may cause the level of Relpax in your body to become too high.

If the level of Relpax in your body gets too high, you’re at an increased risk of side effects. These can be serious and can include heart problems, such as increased blood pressure or heart attack. (For more about side effects, see the “Relpax side effects” section above.)

Some combination antiviral drugs also contain ritonavir. So if you’re taking any antiviral medication, talk with your doctor before you start to use Relpax.

Relpax and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Relpax. However, you should still check with your doctor or pharmacist before using any of these products while taking Relpax.

There are no known interactions between alcohol and Relpax. However, drinking alcohol can trigger migraine attacks. People with migraine often avoid alcohol or only drink a small amount to help prevent migraine from occurring.

If you drink alcohol and are concerned about how it might affect migraine, talk with your doctor. They can tell you how much is safe for you to drink during your treatment.

It’s not known if Relpax is safe to use during pregnancy. There are no studies that show the effects of Relpax in pregnant women.

However, studies in pregnant animals who were given Relpax showed an increased risk of certain problems in the babies. These included low birth weight, heart defects, and problems with their spine and the bones in their chest. However, the results of animal studies may not apply to humans.

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Relpax. They may recommend a different medication to treat your migraine.

It’s not known if Relpax is safe to take during pregnancy. In animal studies, Relpax caused low birth weight, heart defects, and changes in the way certain bones grow. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Relpax.

It’s not known if Relpax is safe to take while breastfeeding. However, Relpax is present in the breast milk of mothers who take the medication. This means that a breastfed baby will be exposed to the medication. There are no current studies on breastfeeding women taking Relpax.

If you’re breastfeeding or plan to breastfeed, talk with your doctor before taking Relpax. They may recommend a different medication or treatment to help ease your migraine.

You should take Relpax according to your doctor’s or healthcare provider’s instructions.

Your doctor will tell you exactly how much Relpax to use and how often you can use it. You’ll take one tablet of Relpax by swallowing it as soon as you feel symptoms of migraine. Usually, if you don’t feel better within 2 hours after taking your dose of Relpax, you can take a second dose.

You should never take more than 80 mg of Relpax in 24 hours. It may be helpful to write down your symptoms and if the medication is working for you. This can help your doctor see if Relpax is a good choice for you, or if another medication may work better to ease your migraine.

When to take

You should take Relpax only if you feel migraine starting to occur. You shouldn’t take the medication every day. Relpax doesn’t prevent migraine; it only treats current migraine.

Taking Relpax with food

You can take Relpax with or without food. Sometimes migraine may cause nausea, and you may not feel like eating. So know that you can take Relpax without food to treat a current migraine headache.

Can Relpax be crushed, split, or chewed?

You should swallow Relpax tablets whole. You shouldn’t break, crush, or chew them.

Relpax is a medication that’s used to stop a current migraine. It belongs to a class of medications called triptans. (A class of medications is a group of drugs that work in a similar way.)

It’s not known exactly why migraine occurs. However, the condition is believed to be due to swollen blood vessels in your head. These swollen blood vessels can cause severe head pain and other symptoms of migraine. Your body may also release certain chemicals that contribute to your symptoms of migraine.

Relpax works by increasing the level of a chemical called serotonin in your brain. This helps narrow blood vessels in your head that may be swollen during migraine. The drug also stops your body from releasing the chemicals that may play a part in your symptoms.

How long does it take to work?

Relpax can take about 2 hours to start working. Because medications work differently in different people, Relpax may work more quickly or more slowly than 2 hours.

In clinical trials, between 53.9% and 65% of people who took Relpax had a decreased headache 2 hours after their dose. “Decreased headache” was defined as a moderate to severe headache that became a mild headache or no headache at all.

In comparison, between 19% and 39.5% of people who took a placebo (treatment with no active drug) had a decreased headache 2 hours after their dose.

As with all medications, the cost of Relpax can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Relpax. This means that your doctor will need to send a request to your insurance company asking them to cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Relpax.

If you’re not sure if you’ll need to get prior authorization for Relpax, contact your insurance company.

Financial assistance

If you need financial support to pay for Relpax, help is available. U.S. Pharmaceuticals, the manufacturer of Relpax, offers the Relpax Savings Card. For more information and to find out if you’re eligible for support, call 800-926-5334 or visit the program website.

Here are answers to some frequently asked questions about Relpax.

Will Relpax make me sleepy?

It might. A side effect of Relpax is feeling drowsy, so you may feel more tired after taking your dose. In clinical trials of Relpax, 6% of people who took a 40-mg dose felt sleepy afterward. In comparison, 4% of people who took a placebo (treatment with no active drug) also felt sleepy.

If you don’t know how Relpax will affect you, don’t drive a car or use machinery during your treatment. Because the medication may make you drowsy, driving can be dangerous.

If you’re concerned about becoming drowsy while taking Relpax, talk with your doctor.

Can Relpax cause a heart attack?

It’s possible that Relpax could cause a heart attack, but this side effect is very rare. There have been reports of heart attacks and other serious heart problems within a few hours after a dose of Relpax.

You shouldn’t take Relpax if you have a history of coronary artery disease (CAD). This is because you may be at an increased risk for a heart attack.

Risk factors for a heart attack include high blood pressure, smoking, diabetes, and obesity. If you have more than one of these risk factors, your doctor may give you your first dose of Relpax in their office. They can monitor your heart right after you take the medication to make sure Relpax isn’t causing any heart-related side effects.

If you’re concerned about the risk of heart attack while taking Relpax, talk with your doctor.

Why should I always carry Relpax with me?

You should always have Relpax with you because you never know when migraine may start. Relpax works best when you take it as soon as you feel migraine starting. If you don’t have the medication with you, you won’t be able to take it right away, and your migraine may become worse.

Does Relpax prevent migraine?

No, Relpax doesn’t prevent migraine from occurring. This medication works to stop the symptoms of current migraine. If you have migraine very often, talk with your doctor about using other medications to prevent migraine.

How can I track migraine while taking Relpax?

Keeping track of your migraine can be very helpful in treating the condition. You can keep a notebook or diary where you write down details of your migraine, including what you recently did, that may have caused migraine to occur. You should also include where the pain is occurring, if you’re having other symptoms, and how long the migraine headache lasts.

There are also migraine tracking apps that you can download on your smartphone. These apps make it easy to record your symptoms while you’re out and even share them with your doctor.

Recording or writing about your migraine will help you recognize triggers, which are things that may cause your migraine. These can include stress and changes in your sleep. You should also write down how long migraine lasted. This can also help your doctor see if Relpax is working for you, or if you should try something else.

Why was Relpax recalled?

Relpax was recalled in 2019 because certain pills may have had bacteria in them. The 40-mg tablets were the only ones that were involved in the recall. Only certain batches of the medication were affected.

The bacteria that the tablets were contaminated with usually don’t cause any problems for people with an active immune system. (Your immune system is your body’s defense against infection.) However, people with a weak immune system can get very sick from these bacteria. There have been no reports of sickness from the bacteria in Relpax.

If you have questions about your Relpax tablets and whether they may have been involved in the recall, talk with your pharmacist. They’ll look to see if your medication was recalled. If your Relpax medication has been recalled, your pharmacy will be able to replace it for you. Or you can call Stericycle at 877-225-9750. They can help reimburse you for the medication.

This drug comes with several precautions. Before taking Relpax, talk with your doctor about your health history. Relpax may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Heart disease. You shouldn’t take Relpax if you have a history of coronary artery disease (CAD) or vasospasm (narrowing of the blood vessels near your heart), including heart attack. Relpax can increase your risk for heart attack and stroke. If you already have heart disease, your risk can be increased even more. Talk with your doctor before starting to take Relpax and tell them about any heart disease you may have. They may suggest a different medication to help ease your migraine symptoms.
  • Heart disease risk factors. Relpax can increase your risk for heart attack. So before you start taking the medication, your doctor will see if you have any risk factors for heart disease. These can include a family history of heart disease, smoking, high blood pressure, high cholesterol, diabetes, stress, and obesity. If you have any of these risk factors, your doctor may monitor your heart. And if you’re at a very high risk of developing heart disease, your doctor may monitor you often or recommend different migraine medication.
  • Wolff-Parkinson-White syndrome or another conduction disorder. If you have any condition that may affect the electrical pathways in your heart, such as Wolff-Parkinson-White syndrome, you shouldn’t take Relpax. This is because Relpax can cause changes in your heart rhythm. If you already have a heart condition, Relpax may put you at higher risk for serious events such as a heart attack. Ask your doctor about other medication to help relieve your migraine symptoms.
  • Stroke or transient ischemic attack. You shouldn’t take Relpax if you’ve had a stroke or transient ischemic attack (a mini-stroke) in the past. This is because Relpax works by narrowing blood vessels in your brain, which can increase your risk for stroke. If you have a history of a stroke, you’re also at an increased risk of having another one. Talk with your doctor about a different medication to help ease your migraine symptoms.
  • Basilar or hemiplegic migraine. People who have basilar migraine or hemiplegic migraine are at an increased risk of stroke. (Basilar migraine occurs in the brain stem, and hemiplegic migraine causes weakness on one side of the body.) Because Relpax also increases your risk for a stroke occurring, you shouldn’t take Relpax if you have these conditions. Talk with your doctor about a different medication to help ease your migraine symptoms.
  • Peripheral vascular disease. You shouldn’t take Relpax if you have peripheral vascular disease (PVD), which is a circulation disorder. An example of PVD is Raynaud’s syndrome (lack of blood flow to your nose, ears, fingers, or toes). Relpax works by narrowing your blood vessels. And because PVD also narrows blood vessels, taking Relpax can make your condition worse. Ask your doctor about other medication to help relieve your migraine symptoms.
  • Ischemic bowel disease. If you have ischemic bowel disease, blood flow to your bowel is decreased. Because Relpax works by narrowing blood vessels, the drug can make your condition worse. So you shouldn’t take Relpax if you have ischemic bowel disease. Talk with your doctor about a different medication to help ease your migraine symptoms.
  • High blood pressure that isn’t well managed. Relpax may increase your blood pressure. If your blood pressure isn’t well managed, Relpax may increase your blood pressure to a level that’s very unsafe. This can cause serious effects such as heart attack or stroke. If you have high blood pressure that isn’t well managed, ask your doctor about a different medication that may help ease your migraine symptoms.
  • Allergic reaction to Relpax. If you’ve had an allergic reaction to Relpax in the past, you shouldn’t take the medication. Sometimes allergic reactions can be very serious and can cause you to have trouble breathing. Talk with your doctor about other ways to ease migraine.
  • Pregnancy. It’s not known if Relpax is safe to use during pregnancy. For more information, please see the “Relpax and pregnancy” section above.
  • Breastfeeding. It’s not known if Relpax is safe to take while breastfeeding. For more information, please see the “Relpax and breastfeeding” section above.

Note: For more information about the potential negative effects of Relpax, see the “Relpax side effects” section above.

Using more than the recommended dosage of Relpax can lead to serious side effects. You should never take more than 80 mg of Relpax in a 24-hour period. No overdoses occurred in clinical trials of the drug.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Relpax from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Relpax tablets at room temperature (between 68°F to° 77°F/20°C to 25°C). If necessary, you can keep the medication at 59°F to 86°F/(15°C to 30°C) for short periods of time. Avoid storing Relpax in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Relpax and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Relpax is indicated for use in patients with a clear diagnosis of migraine with or without aura. It should not be used to treat cluster headaches. Relpax doesn’t prevent migraine. Instead, the medication aborts currently ongoing migraine.

Mechanism of action

It is believed that migraine occurs due to vasodilation of intracranial blood vessels. The condition may also occur due to stimulation of the trigeminal nerve, which causes neuropeptide release and then vasodilation in the brain.

Relpax is a serotonin agonist. It binds to 5-HT1B, 5-HT1D, and 5-HT1F receptors with a strong affinity. It also binds to 5-HT1A, 5-HT1E, 5-HT2B, and 5-HT7 receptors with modest affinity.

It works by agonizing the 5-HT1B and 5-HT1D receptors in the brain, causing vasoconstriction of cranial vessels. Relpax also inhibits the release of pro-inflammatory neuropeptides that may contribute to the symptoms of migraine.

Pharmacokinetics and metabolism

Relpax is well absorbed after it is taken. In people with moderate to severe migraine, the time to maximum plasma concentration was about 2 hours. About 50% of the oral dosage is bioavailable.

Relpax is about 85% bound to plasma proteins.

The half-life of Relpax is about 4 hours. It is primarily metabolized in the liver by cytochrome P450 (CYP) 3A4.

There is an active metabolite of Relpax due to N-demethylation. The half-life of the active metabolite is longer than Relpax (about 13 hours), but its plasma concentration reaches only 10% to 20% that of the parent drug. Therefore, the active metabolite is unlikely to contribute to the therapeutic effects of Relpax.

Contraindications

Relpax is contraindicated in people with the following conditions:

Relpax is also contraindicated in people who have taken other 5-HT1 agonists or ergot-containing medications within 24 hours. This is because all of these medications can increase levels of serotonin, and this may put the patient at risk of serotonin syndrome.

Another contraindication to using Relpax is taking any of the following medications within the last 72 hours:

These medications are potent CYP3A4 inhibitors. Since CYP3A4 is the main enzyme that metabolizes Relpax, inhibiting it can cause an increased concentration of Relpax in the body. This can lead to serotonin syndrome and other serious side effects.

Storage

Relpax should be stored at room temperature between 68°F to 77°F (20°C to 25°C). However, brief excursions are allowed for storage between 59°F to 86°F (15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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