Age Requirements for Starting Nurtec (Rimegepant)
Nurtec ODT (rimegepant) is approved for use only in adults aged 18 years and older for both acute treatment and prevention of migraine. 1
FDA-Approved Age Range
- Nurtec ODT is indicated for adults (≥18 years) with a history of migraine, as demonstrated in all clinical trials that specifically enrolled adult participants 1, 2
- Clinical studies establishing the safety and efficacy of rimegepant consistently included only adult participants with a mean age of approximately 40-41 years 2, 3
- No clinical trials have evaluated the safety or efficacy of Nurtec in pediatric populations under 18 years of age 1, 4
Age-Specific Considerations for Migraine Treatment
- For children and adolescents with migraine, different treatment approaches are recommended:
- Bed rest alone might suffice as first-line treatment for pediatric migraine 5
- If medication is needed, ibuprofen is recommended as the first-line acute treatment for children 5
- For pediatric migraine prevention, propranolol, amitriptyline, or topiramate are recommended options rather than CGRP antagonists like rimegepant 5, 6
Safety Considerations
- The FDA label for Nurtec ODT does not include specific dosing instructions for pediatric patients, further confirming it is not approved for use in children 1
- Hypersensitivity reactions, including dyspnea and rash, have occurred with Nurtec ODT in clinical studies and should be monitored in all patients 1
- Long-term safety studies have only been conducted in adult populations, with no data available on safety in pediatric patients 3
Alternative Options for Pediatric Migraine
- For children requiring migraine prevention, the American Academy of Neurology recommends:
- For acute treatment in children, ibuprofen has demonstrated efficacy and safety 5
Common Pitfalls to Avoid
- Do not prescribe Nurtec to patients under 18 years of age as safety and efficacy have not been established in this population 1, 2
- Do not use Nurtec in patients with a history of hypersensitivity to rimegepant or any components of Nurtec ODT 1
- Avoid concomitant administration of Nurtec with strong inhibitors of CYP3A4, which can significantly increase rimegepant exposure 1
Remember that migraine treatment approaches differ significantly between adults and children, with specific pediatric options available that have been studied in appropriate age groups 5, 6.