From the Guidelines
Nurtec (rimegepant) is recommended for the acute treatment of migraine headaches in adults, with a dose of 75 mg taken orally as needed, and a maximum of one dose per 24 hours, due to its effectiveness in providing pain relief at 2 hours, as shown in studies 1. For acute treatment, Nurtec works by blocking calcitonin gene-related peptide (CGRP) receptors, which are involved in pain transmission during migraines. Unlike older migraine medications, Nurtec doesn't constrict blood vessels, potentially making it safer for people with cardiovascular concerns. Common side effects include nausea and stomach discomfort. The medication comes as an orally disintegrating tablet that dissolves on the tongue without requiring water. Patients should avoid taking Nurtec with strong CYP3A4 inhibitors (like certain antibiotics or antifungals) and should inform their doctor about all medications they're taking to prevent interactions. If you're pregnant, planning pregnancy, or breastfeeding, consult your healthcare provider before using Nurtec. However, there is insufficient evidence to recommend for or against rimegepant for the prevention of episodic migraine, as stated in the 2023 guideline 1. It's essential to weigh the benefits and risks of using Nurtec, considering the patient's medical history, comorbidities, and potential interactions with other medications, as suggested by the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1. In clinical practice, healthcare providers should consider the individual patient's needs and preferences when deciding on a treatment plan for migraine headaches, taking into account the latest evidence-based recommendations and guidelines.
From the FDA Drug Label
NURTEC ODT is a prescription medicine used in adults for the: • acute treatment of migraine attacks with or without aura • preventive treatment of episodic migraine
Nurtec is used for the acute treatment of migraine attacks and preventive treatment of episodic migraine in adults.
- The most common side effect of Nurtec in acute treatment is nausea.
- The most common side effects of Nurtec in preventive treatment are nausea, stomach pain, and indigestion. 2 2 2
From the Research
Overview of Nurtec
- Nurtec, also known as Rimegepant, is a calcitonin gene-related peptide (CGRP) receptor antagonist approved for the acute treatment of migraine with or without aura in adults, and for the preventive treatment of episodic migraine in adults 3.
- It is available as an orally disintegrating tablet (ODT), which offers convenience and a potentially faster response time than the conventional tablet formulation 3.
Efficacy of Nurtec
- Rimegepant was more effective than placebo at relieving pain and the most bothersome symptom when taken as needed for the acute treatment of migraine 3, 4.
- It was also 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.
Safety and Tolerability of Nurtec
- Rimegepant was generally well tolerated, with no evidence of hepatotoxicity or cardiovascular toxicity in clinical trials 3, 5.
- The most common adverse events were nausea and urinary tract infection 4.
- Rimegepant has a favorable safety profile, making it appropriate for many patients, particularly those with contraindication, intolerance, or inadequate response to other classes of standard-of-care migraine treatments 6.
Comparison with Other Migraine Treatments
- There are few head-to-head studies with other migraine treatments to determine relative efficacy 6.
- However, the favorable safety profile of rimegepant makes it a useful option for the management of migraine in adults 3, 5.
- Additional studies on the efficacy and cost-effectiveness relative to other treatments may further define the role of rimegepant in migraine treatment 6.