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What is Nurtec (rimegepant)?

Nurtec ODT is a prescription drug used to treat migraine episodes in adults, with or without aura.

Aura is a combination of sensory symptoms that occur before or during a migraine episode. They are sensory distortions, including tunnel vision, tingling sensations, and flashing lights.

Nurtec is a calcitonin gene-related peptide (CGRP) receptor blocker. It blocks CGRP receptors in the brain. CGRPs are peptides (amino acids). They are believed to play a role in the development of migraines.

By blocking the receptors CGRPs bind to, Nutrec inhibits their biological activity. This improves symptoms or prevents migraines from getting worse.

Rimegepant is the generic name of Nurtec ODT.

What is Nurtec used to treat?

Nurtec is used as an acute treatment for migraines in adults. Doctors also prescribe it as a preventive treatment for migraines.

There is no evidence¹ that Nurtec is effective and safe for children. Under 18s were excluded from all trials, and doctors do not prescribe it to people who are younger than 18 years old.

Nurtec has only been approved to treat and prevent episodic migraine (migraine attacks that occur on less than 14 days per month). It has not been approved to treat chronic migraine, which lasts more than 15 days per month.

How do you take Nurtec?

Take Nurtec oral disintegrating tablet as a 75mg² dose.

For acute migraine treatment, take no more than 75mg in a 24-hour period.

For migraine prevention, take 75mg every other day.

Place the Nurtec tablet on top of your tongue or underneath it. Let it dissolve in your mouth before swallowing. You don’t need to take it with water.

Seeing results

You may feel Nurtec working within an hour.³ Its pain-relieving effect has been found to last for up to 48 hours after a single dose.

More than 80%³ of people who took the drug did not need to take any other migraine medication in the next 24 hours.

When taking Nurtec to prevent migraines, you may notice having fewer migraines each week in two to three months.

Potential side effects of Nurtec

Nausea and stomach pain are the most common reported side effects of Nurtec.

Nurtec may also cause more serious side effects requiring urgent medical attention, including:

  • Heartburn

  • Indigestion

  • Bloating

Hypersensitivity or allergic reactions affect less than 1%⁴ of patients in Nurtec clinical trials, with symptoms such as skin rash and dyspnea (shortness of breath).

Long-term use of Nurtec

Intermittent long-term Nurtec use at 75mg for treating two migraine attacks per month for a duration ranging from six months to a year was found to be safe⁴ in a clinical trial.

Missed doses

As a treatment for an acute migraine attack, you may need to take Nurtec only when the first signs of symptoms appear.

However, when taking a scheduled dose of 75mg every other day as a preventive treatment, it is possible to miss a dose.

Take a missed Nurtec dose as soon as you remember to, but not when it is almost time to take your next dose.

Do not take two doses at once.

Overdoses

If you think you or someone else has taken too much Nurtec, seek medical help urgently.

What to discuss with your doctor before taking Nurtec

Before taking Nurtec, tell your doctor about the following if they apply to you:

  • Preexisting health conditions, including liver or kidney conditions.

  • Allergy to Nurtec, any of its ingredients, or any other medication.

All other medications (prescription and over-the-counter), supplements, and herbal medicines that you are currently taking or plan to take.

  • Pregnancy and breastfeeding. You must tell your doctor if you plan to become pregnant while taking Nurtec.

  • Inform your doctor if you consume alcohol. Alcohol may trigger migraines and may cause liver damage.

  • Planned surgery (including dental surgery).

Discuss your treatment strategy, dosing schedule (if applicable), and potential side effects of Nurtec with your doctor before taking it. Be sure to ask for clarification if you have any questions.

Stopping Nurtec

Nurtec is not thought to cause withdrawal symptoms, and unlike other migraine medicines, Nurtec does not cause rebound headaches. Rebound headaches could occur when a migraine medicine is taken too often or misused. This worsens the severity and frequency of the headache.

Talk to your doctor if you want to stop taking Nurtec, particularly if they prescribed the medicine for long-term use.

Don’t stop taking Nurtec without your doctor’s guidance.

Nurtec and pregnancy

No conclusive studies have shown adverse effects of taking Nurtec during pregnancy for either the mother or baby. However, animal studies⁴ suggest an increased risk of low birth weight and congenital disabilities.

Ask your doctor about using Nurtec while pregnant and tell them if you have plans to get pregnant while taking the medication.

Breastfeeding

A study⁵ showed rimegepant was excreted into human breast milk in a very small quantity. The study estimated that a nursing baby would receive less than 1% of the mother’s dose on a weight-adjusted basis. This is much lower than the commonly cited safety threshold, which is 10% of the maternal dose, or approximately 2mg per kilogram.

If you are breastfeeding or planning to do so, ask your doctor about other healthy and safe alternatives to Nurtec.

Interactions with other drugs

Among the drugs that may interact with Nurtec are the following:

  • Strong CyP3A4 inhibitors: Drugs such as clarithromycin (Biaxin), atazanavir (Reyataz), and itraconazole (Onmel or Sporanox) could prevent your body from breaking down Nurtec and increase its side effects.

  • Moderate CYP3A4 inhibitors: Drugs like amiodarone (Cordarone or Pacerone), diltiazem (Cardizem), and fosamprenavir (Lexiva) can prevent your body from breaking down Nurtec, but less so than strong CyP3A4 inhibitors.

  • Some CYP3A4 inducers: Drugs like carbamazepine (Epitol or Tegretol), rifampin (Rifadin), and phenytoin (Dilantin) could break down Nurtec faster, rendering it ineffective in treating migraines.

  • Some drugs like cyclosporine (Gengraf, Sandimmune, or Neoral), verapamil (Calan or Verelan), and sulfasalazine (Azulfidine) could increase levels of Nurtec in the body, increasing your risk of side effects.

Some foods and herbal supplements may also interact with Nurtec. Among these are:

  • Alcohol

  • St John’s wort

  • Grapefruit/grapefruit juice (don’t consume grapefruit within 48 hours of taking Nurtec as it can impact your metabolism and the concentration of the medication in your body)

Allergy information

Nurtec can cause allergic reactions. Possible symptoms of an allergic reaction to Nurtec include:

  • Skin rashes

  • Swelling of the feet, hands, and fingers

  • Shortness of breath

Stop taking Nurtec and seek emergency medical help if you think you or someone else is having an allergic reaction to the drug.

Clinical trial history

The US Food and Drug Administration (FDA) approved Nurtec ODT based on findings from one clinical trial.⁶ The trial involved 1,351 people with migraine with or without aura in the US.

Patients were randomly assigned Nurtec or placebo. The trial participants and doctors did not know which treatment they were receiving until after the trial’s completion.

The drug’s efficacy was assessed by looking at the percentage of patients who were pain-free within two hours of treatment compared with participants who took a placebo.

Researchers found that Nurtec ODT was significantly more effective than placebo.

Tips and advice for taking Nurtec

Here are some tips and advice for taking Nurtec safely and effectively:

  • Discuss with your doctor exactly what you are taking the drug for. Are you taking the drug as an acute or preventative treatment?

  • Never chew, split, or break the tablet.

  • Make sure your hands are dry when you open the blister pack.

  • Place the medicine on or under your tongue. You don’t need to drink or eat anything, as the tablet will dissolve quickly.

  • Keep the tablet in the packet until you need to take your dose.

  • For acute treatment, take Nurtec when you start having symptoms.

  • Whether as an acute or preventive treatment, you can only take a maximum of 18 tablets of Nurtec per month.⁷

  • Tell your doctor if you do not have any improved symptoms.

  • Don’t stop taking Nurtec unless your doctor tells you to.

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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