What should I do if I experience hives while taking Qulipta (atogepant)?

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From the Guidelines

If you experience hives while taking Qulipta (atogepant), you should contact your healthcare provider immediately and stop taking the medication, as this may indicate an allergic reaction. While waiting to speak with your doctor, you can take an over-the-counter antihistamine like diphenhydramine (Benadryl) to help manage the hives temporarily, and apply cool compresses to affected areas for relief. Hives (urticaria) are raised, itchy welts that occur when your body releases histamine in response to an allergen, which in this case may be atogepant or an inactive ingredient in Qulipta. Your doctor might recommend switching to a different migraine preventive medication if they determine Qulipta is causing the reaction, such as erenumab, fremanezumab, or galcanezumab, which have been shown to be effective in preventing episodic and chronic migraine 1. Make sure to report all symptoms you experience, as this will help your healthcare provider determine the severity of your reaction and guide appropriate treatment decisions. It's also important to note that atogepant has been suggested for the prevention of episodic migraine, but with a "weak for" recommendation, indicating that the evidence is not as strong as for other medications 1. In any case, prioritizing your safety and well-being is crucial, and seeking medical attention promptly is the best course of action if you experience any severe symptoms or allergic reactions while taking Qulipta. Additionally, the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache suggests that patients with migraines may benefit from a combination of pharmacologic and nonpharmacologic therapies, including lifestyle modifications and behavioral interventions 1. However, the primary concern in this situation is addressing the potential allergic reaction and ensuring your safety.

From the FDA Drug Label

QULIPTA can cause serious side effects, including: Allergic (hypersensitivity) reactions, including anaphylaxis: Serious allergic reactions can happen when you take QULIPTA or days after Stop taking QULIPTA and get emergency medical help right away if you get any of the following symptoms, which may be part of a serious allergic reaction: swelling of the face, lips, or tongue itching trouble breathing hives rash Inform patients about the signs and symptoms of hypersensitivity reactions and that these reactions can occur with QULIPTA. Advise patients to discontinue QULIPTA and seek immediate medical attention if they experience any symptoms of a hypersensitivity reaction

If you experience hives while taking Qulipta (atogepant), you should:

  • Stop taking QULIPTA
  • Seek immediate medical attention 2

From the Research

Hives from Qulipta (Atogepant)

If you experience hives while taking Qulipta (atogepant), it is essential to understand the potential causes and appropriate actions.

  • Hives, also known as urticaria, are characterized by itchy, raised welts on the skin that can appear and disappear quickly [ 3 ].
  • The exact mechanism of hives from Qulipta is not explicitly stated in the provided studies, but it is crucial to recognize that atogepant is a calcitonin gene-related peptide (CGRP) receptor antagonist [ 4 ].

Potential Causes and Actions

  • While the studies do not directly address hives as a side effect of Qulipta, they do mention other adverse events such as constipation and nausea [ 5, 6 ].
  • If you experience hives or any other severe side effects, it is recommended to consult your healthcare provider for proper evaluation and guidance.
  • Your healthcare provider may consider alternative treatments or adjust your dosage to minimize adverse effects [ 5, 6 ].

Management of Hives

  • For the management of chronic idiopathic urticaria (CIU), systemic histamine H1-receptor antagonists, such as desloratadine, have been shown to be effective [ 3 ].
  • However, it is essential to note that the treatment of hives caused by Qulipta may require a different approach, and you should follow the advice of your healthcare provider.

Allergic-Type Reactions

  • Allergic-type reactions to medications, including corticosteroids, can occur, and it is crucial to be aware of the potential symptoms, such as rash, sneezing, dyspnea, edema, bronchospasm, or death [ 7 ].
  • If you suspect an allergic reaction to Qulipta, seek medical attention immediately.

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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