What are the considerations for switching from Aimovig (Erenumab) injection to Qulipta (Atogepant) oral tablets?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

Switching from Aimovig injections to Qulipta oral tablets can be done under medical supervision without a washout period, with the last dose of Aimovig taken as scheduled and Qulipta started the following month at a dose of 10 mg or 30 mg once daily.

Key Considerations

  • Both medications work as CGRP pathway blockers for migraine prevention, but through slightly different mechanisms, with Aimovig blocking the CGRP receptor and Qulipta blocking the CGRP peptide itself 1.
  • The switch may be beneficial if you prefer daily oral medication over monthly injections, experienced side effects with Aimovig, or had inadequate response to Aimovig.
  • Common side effects of Qulipta include nausea, constipation, and fatigue, as noted in the 2023 VA/DoD headache guidelines 1.

Dosing and Administration

  • Qulipta is typically started at 10 mg or 30 mg once daily, with 60 mg daily being the maximum approved dose.
  • It is essential to inform your doctor about all other medications you take, as Qulipta has some drug interactions that may require dose adjustments.

Insurance Coverage and Prior Authorization

  • Insurance coverage may differ between these medications, so it is crucial to check with your provider about prior authorization requirements.

Medical Supervision

  • Switching from Aimovig to Qulipta should be done under medical supervision to ensure a smooth transition and to monitor for any potential side effects or interactions.
  • The 2023 VA/DoD headache guidelines provide evidence-based recommendations for the evaluation and treatment of headache, including the use of CGRP monoclonal antibodies and gepants for migraine prevention 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Switching from Aimovig Injection to Qulipta Oral Tablets

  • The provided studies do not directly address switching from Aimovig injection to Qulipta oral tablets.
  • However, the studies discuss the efficacy and safety of rimegepant (an oral calcitonin gene-related peptide receptor antagonist) for the acute and preventive treatment of migraine 2, 3, 4, 5.
  • One study compares the efficacy of erenumab versus rimegepant for migraine prevention, finding that erenumab had a more favorable efficacy profile than rimegepant in reducing monthly migraine days 6.
  • Rimegepant has been found to be well-tolerated and effective in decreasing pain and symptoms associated with migraine attacks 2, 3, 4, 5.
  • The decision to switch from one medication to another should be made on a case-by-case basis, taking into account individual patient needs and medical history, as there are no direct studies on switching from Aimovig to Qulipta.

Key Considerations

  • Rimegepant is an oral medication, whereas Aimovig is an injection, which may be an important consideration for patients who prefer or require oral medications.
  • The studies suggest that rimegepant is generally well-tolerated, but patients should be monitored for potential adverse events, such as nausea and urinary tract infections 2.
  • Further research is needed to determine the long-term consequences of CGRP blockade and the potential effects of combining rimegepant with other antimigraine treatments 4.

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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