What are the recommended dosing and potential side effects of Nurtec (rimegepant) for migraine prevention?

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Last updated: June 13, 2025View editorial policy

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From the Guidelines

Nurtec (rimegepant) is recommended for migraine prevention at a dose of 75 mg every other day, with potential side effects including nausea, fatigue, and upper respiratory tract infections, as supported by recent clinical guidelines 1. When considering Nurtec for migraine prevention, it's essential to evaluate the patient's current treatment regimen and assess whether they are using appropriate and adequate-strength medications to treat acute migraine headaches.

  • The American College of Physicians suggests that pharmacologic treatment for episodic migraine headache prevention should be considered in people experiencing severe debilitating headaches despite adequate acute treatment, or in those who are unable to tolerate or have contraindications to acute treatment 1.
  • Adherence to pharmacologic treatment is crucial, as improvement may occur gradually after initiation of a long-term treatment option for prevention of episodic migraine, with an effect that may become apparent after the first few weeks of treatment 1.
  • Common side effects of Nurtec include nausea, fatigue, and upper respiratory tract infections, and patients with severe liver impairment should use caution due to the potential risk of liver problems.
  • It's also important to note that Nurtec should not be taken with strong CYP3A4 inhibitors like ketoconazole or clarithromycin, as these can increase rimegepant levels in the blood.
  • The use of a headache diary may help to determine treatment efficacy, identify analgesic overuse, and follow up on migraine progression, allowing for adjustments to the treatment plan as needed 1.

From the FDA Drug Label

2.2 Recommended Dosing for Preventive Treatment of Episodic Migraine The recommended dosage of NURTEC ODT is 75 mg taken orally every other day.

6 ADVERSE REACTIONS The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling: • Hypersensitivity Reactions [see Warnings and Precautions (5.1)]

The recommended dosing of Nurtec (rimegepant) for migraine prevention is 75 mg taken orally every other day. Potential side effects include hypersensitivity reactions, which can occur days after administration, and delayed serious hypersensitivity has occurred 2.

From the Research

Recommended Dosing of Nurtec for Migraine Prevention

  • The recommended dosing of Nurtec (rimegepant) for migraine prevention is 75 mg taken every other day 3.
  • Rimegepant is available as an orally disintegrating tablet (ODT), which offers convenience and a potentially faster response time than the conventional tablet formulation 3.

Potential Side Effects of Nurtec for Migraine Prevention

  • Rimegepant was generally well tolerated, with no evidence of hepatotoxicity or cardiovascular toxicity in clinical trials 3, 4.
  • The most common adverse events reported in clinical trials were nausea and dizziness 4.
  • There is no evidence of drug-induced liver injury due to rimegepant 4.
  • Rimegepant does not induce vasoconstriction, and is therefore not contraindicated in patients with cardiovascular disease 5.
  • Rimegepant does not seem to induce medication-overuse headache 5.

Efficacy of Nurtec for Migraine Prevention

  • Rimegepant was more effective than placebo at reducing the number of monthly migraine days when taken every other day for the preventive treatment of migraine 3.
  • The beneficial effects of rimegepant in reducing migraine frequency and improving quality of life were maintained over the longer term (up to 52 weeks) 3.
  • Rimegepant represents a useful option for the management of migraine in adults, particularly those who have not responded adequately to conventional treatments 6, 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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