From the Guidelines
Ubrelvy (ubrogepant) should be considered for the treatment of acute episodic migraine headache in nonpregnant outpatient adults who do not tolerate or have inadequate response to combination therapy of a triptan and an NSAID or acetaminophen, as per the latest clinical guideline from the American College of Physicians 1. When using Ubrelvy for migraine treatment, several special considerations should be taken into account.
- Patients should be aware of the potential for medication overuse headache, which can occur with frequent use of acute medications, including Ubrelvy 1.
- The importance of lifestyle modifications should be highlighted, including staying well hydrated, maintaining regular meals, securing sufficient and consistent sleep, engaging in regular physical activity, managing stress, and pursuing weight loss if applicable 1.
- Patients should be counseled to begin treatment of migraine headache as soon as possible after its onset, and to be aware of the potential risks and benefits of pharmacologic treatments during pregnancy and lactation 1.
- It is essential to monitor for potential drug interactions, particularly with strong CYP3A4 inhibitors or inducers, and to adjust the dose accordingly.
- Ubrelvy may be a suitable option for patients with cardiovascular risk factors, as it does not cause vasoconstriction like triptans.
- Common side effects of Ubrelvy include nausea, fatigue, and dry mouth, and patients should be advised that it may take 1-2 hours for full effect and can be taken with or without food.
- The recommended dose of Ubrelvy is 50-100 mg as needed, not exceeding 200 mg in 24 hours or treating more than 8 migraines per month, and liver impairment patients may require dose adjustments 1.
From the FDA Drug Label
UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. Before you take UBRELVY tell your healthcare provider about all of your medical conditions, including if you: have liver problems have kidney problems are pregnant or plan to become pregnant. It is not known if UBRELVY will harm your unborn baby. are breastfeeding or plan to breastfeed. It is not known if UBRELVY passes into your breast milk. Do not take UBRELVY if you are taking medicines known as a strong CYP3A4 inhibitor, such as ketoconazole, clarithromycin, or itraconazole.
The special considerations for using Ubrelvy (ubrogepant) in patients with migraines include:
- Liver and kidney problems: Patients with liver or kidney problems should inform their healthcare provider before taking Ubrelvy.
- Pregnancy and breastfeeding: It is not known if Ubrelvy is safe during pregnancy or breastfeeding, and patients should inform their healthcare provider if they are pregnant, plan to become pregnant, or are breastfeeding.
- Medication interactions: Patients should inform their healthcare provider about all medications they are taking, including strong CYP3A4 inhibitors, as these may interact with Ubrelvy 2.
- Dosing limitations: Most patients can take a second tablet 2 hours after the first tablet, as needed, but should not take a second tablet within 24 hours if they consume grapefruit or grapefruit juice or are taking certain medications 2.
From the Research
Special Considerations for Ubrelvy (Ubrogepant)
Overview of Ubrogepant
- Ubrogepant is an orally bioavailable calcitonin gene-related peptide (CGRP) receptor antagonist approved for the acute treatment of migraine headaches with or without aura in adults 3.
- It is the first oral CGRP receptor antagonist approved for the acute treatment of migraine.
Administration and Dosage
- Ubrogepant can be administered as 50- and 100-mg tablets, with a maximum dose of 200 mg within 48 hours 3.
- The drug is effective in alleviating migraine-associated symptoms such as nausea, photophobia, and sound sensitivity 3.
Safety and Tolerability
- Ubrogepant has been shown to be safe and well-tolerated in clinical trials, with a low incidence of treatment-related adverse events and serious adverse events 4.
- The most commonly reported adverse events include upper respiratory tract infection, nausea, somnolence, and dry mouth 4, 5.
- Ubrogepant is not effective as a preventive migraine therapy 3.
Patient-Reported Outcomes
- Ubrogepant has been shown to improve patient-reported functional disability, satisfaction with study medication, and global impression of change in clinical trials 6.
- A significantly higher proportion of participants treated with ubrogepant were able to function normally, were satisfied with the study medication, and reported clinically meaningful improvement compared with those receiving placebo 6.