From the Guidelines
Relpax (eletriptan) should be avoided in breastfeeding mothers due to limited safety data and potential risks to the nursing infant. The use of triptans, including Relpax, during breastfeeding is not well established, and their safety profile is a concern 1. While small amounts of the medication may pass into breast milk, the potential risks to the infant are not well understood.
Alternatives for Breastfeeding Mothers
If a breastfeeding mother needs migraine treatment, safer alternatives should be considered, such as:
- Paracetamol (acetaminophen)
- Ibuprofen
- Certain beta-blockers, like propranolol, which have a better safety profile during lactation 1
Precautions with Relpax
If Relpax must be used, it is recommended to temporarily pump and discard breast milk for 24 hours after taking the medication to minimize infant exposure. This precaution is based on the medication's half-life and the precautionary principle, as triptans like Relpax have vasoconstrictive properties that could theoretically affect a developing infant 1.
Consultation with Healthcare Provider
It is essential to consult with a healthcare provider before taking any medication while breastfeeding, as they can help weigh the benefits of treating the migraine against potential risks to the baby and suggest the most appropriate treatment option for the specific situation. The healthcare provider can provide guidance on the safest treatment options and help minimize potential risks to the nursing infant 1.
From the FDA Drug Label
Eletriptan is excreted in human milk. There are no data on the effects of eletriptan on the breastfed infant or the effects of eletriptan on milk production The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for eletriptan hydrobromide and any potential adverse effects on the breastfed child from eletriptan hydrobromide or from the underlying maternal condition. Infant exposure can be minimized by avoiding breastfeeding for 24 hours after treatment.
Relpax (eletriptan) use in breastfeeding mothers:
- Excretion in human milk: Eletriptan is excreted in human milk.
- Effects on breastfed infant: There are no data on the effects of eletriptan on the breastfed infant.
- Recommendation: The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for eletriptan hydrobromide and any potential adverse effects on the breastfed child.
- Minimizing infant exposure: Infant exposure can be minimized by avoiding breastfeeding for 24 hours after treatment 2.
From the Research
Relpax in Breastfeeding Mothers
- There is limited information available on the use of Relpax (eletriptan) in breastfeeding mothers.
- According to a study published in 2006, eletriptan is generally well tolerated, but its safety in breastfeeding mothers is not well established 3.
- Another study published in 2015 suggests that sumatriptan, a similar medication, may be an option during pregnancy for selected patients and is compatible with breast-feeding, but it does not provide specific information on eletriptan 4.
- A review of eletriptan published in 2006 does not mention its use in breastfeeding mothers 5.
- A systematic review published in 2001 does not provide information on the safety of eletriptan in breastfeeding mothers 6.
- Overall, there is limited evidence available to support the use of Relpax in breastfeeding mothers, and its safety in this population is not well established 4, 3, 5, 6.