Nurtec (Rimegepant) Sublingual Absorption
Yes, Nurtec ODT (rimegepant) is absorbed sublingually. The FDA-approved formulation is specifically designed as an orally disintegrating tablet for sublingual or oral use, and bioequivalence studies confirm effective absorption via the sublingual route 1.
Administration and Absorption
The FDA label explicitly states that Nurtec ODT is approved "for sublingual or oral use" 1. The tablet should be placed on or under the tongue where it dissolves without requiring water 1. This sublingual formulation was specifically developed and tested to ensure proper drug absorption.
Bioequivalence Evidence
A rigorous phase 1 bioequivalence study directly compared sublingual administration of the 75 mg ODT formulation against the earlier oral tablet formulation 2. The results demonstrated:
- Area under the curve (AUC) ratios of 97% for both AUC0-t and AUC0-inf
- Maximum concentration (Cmax) ratio of 105%
- All 90% confidence intervals fell within the predefined bioequivalence range of 80-125%
These data confirm that rimegepant 75 mg ODT administered sublingually is bioequivalent to the oral tablet formulation, meaning the sublingual route delivers the same amount of drug to the bloodstream as oral administration 2.
Clinical Implications
The sublingual formulation offers practical advantages:
- No water needed for administration, which is particularly beneficial during migraine attacks when nausea may be present 1
- Rapid dissolution under the tongue
- Flexibility - the tablet can be placed either on or under the tongue with equivalent absorption 2
The bioequivalence between sublingual and oral routes means clinicians can confidently prescribe this formulation knowing that drug exposure is consistent regardless of whether patients place it on top of or under the tongue 2.
Dosing Specifications
For acute migraine treatment: 75 mg taken once as needed, with no more than one tablet in 24 hours 1. For preventive treatment: 75 mg every other day 1. The maximum safe frequency is 18 doses in 30 days 1.