Nurtec ODT

Generic name: Rimegepant
Dosage form: Oral Dispersible Tablet (ODT)
Drug class: CGRP inhibitors

Usage of Nurtec ODT

Nurtec ODT (rimegepant) is used to treat acute migraine attacks (with or without aura) and is also used to prevent episodic migraines.

Nurtec ODT is a Calcitonin gene-related peptide (CGRP) receptor blocker, so it works by blocking CGRP receptors in the brain to reduce migraine symptoms of headache, nausea, vomiting, light sensitivity, and sound sensitivity, and it also can be taken regularly prevent as many as episodic migraines from happening. 

Nurtec is an orally disintegrating tablet (ODT) that dissolves on the tongue or under the tongue, without the need to take it with a glass of water. Because Nurtec ODT dissolves in the mouth, it gets absorbed into the bloodstream very quickly.  Nurtec ODT starts working within one hour to relieve pain from migraine, and in 2 hours 59.3% of migraine patients had pain relief, according to clinical trials.

Nurtec ODT was first approved by the FDA on February 27, 2020.

Nurtec ODT side effects

Nurtec ODT can cause an allergic reaction which can be serious. If you experience any of the following symptoms, you should immediately call your doctor or get emergency medical treatment:

  • difficulty breathing
  • shortness of breath
  • swelling of the throat, tongue, mouth, lips, face or eyes
  • hives
  • rash
  • Itching
  • An allergic reaction called delayed hypersensitivity reactions may occur days after you have taken this medicine and can be severe.

    The most common side effect of Nurtec is nausea, when it is used for acute treatment of migraine attacks.

    When Nurtec ODT is used as a preventive treatment of episodic migraine, its most common side effects are nausea, indigestion and stomach pain.

    This medicine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

    Before taking Nurtec ODT

    Allergies: You should not take Nurtec ODT if you are:

  • allergic to rimegepant or any of the other ingredients contained in the orally disintegrating tablets. See the end of this page for a complete list of ingredients.
  • Kidney or Liver disease: To make sure Nurtec is safe for you, tell your doctor if you have ever have or every had:

  • liver disease; or
  • kidney disease (or if you are on dialysis).
  • Age: Rimegepant is not approved for use by anyone younger than 18 years old.

    Nurtec ODT and Pregnancy:

    Tell your healthcare professional if you are pregnant or plan to become pregnant. It is not known if this medicine will harm your unborn baby. Having migraine headaches may cause complications during pregnancy such as dangerously high blood pressure (preeclampsia) that can lead to medical problems in both mother and baby. Your healthcare provider or doctor will help you decide whether the benefit of treating your migraine outweighs any risk to your baby.

    There is a pregnancy exposure registry for women who take Nurtec ODT during pregnancy. The study is named MONITOR (Migraine Observational NURTEC Pregnancy Registry). A registry is a study. The purpose of this registry is to collect information about your health and the health of your baby. You may enroll yourself, or your healthcare provider can help you enroll in this registry.

    Nurtec ODT and Breastfeeding:

    Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Very small amounts of this medicine will pass into your breast milk. Talk with your healthcare provider about the best way to feed your baby if you take Nurtec ODT.

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    How to use Nurtec ODT

    Acute treatment of migraine (with or without aura) when migraine occurs:

  • One tablet (75mg) as needed, when you have a migraine.
  • Maximum of one tablet in a 24-hour period.
  • The safety of using more than 18 doses in a 30-day period is currently not known.
  • Preventative treatment of episodic migraine:

  • One tablet (75mg) every other day (every 48 hours)
  • Warnings

    It is not known if it is safe to take Nurtec ODT for more than 15 migraine headaches in 30 days.

    Nurtec ODT can be taken once a day as needed, to treat an acute migraine. You should not take more than 1 tablet in 24 hours. Nurtec ODT can be taken every second day to prevent episodic migraine. The safety of using more than 18 doses in a 30-day period has not been established.

    Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

    What other drugs will affect Nurtec ODT

    Sometimes other prescription medicines, nonprescription medicines, vitamins, nutritional supplements, and herbal products, that you are taking or plan to take can interact with Nurtec ODT. It is important to tell your doctor about any other products you are taking or when you start or stop taking them.

    Important drug interactions can happen between Nurtec ODT and the following medicines, so if you are taking any of these you should tell your doctor, pharmacist or healthcare professional:

  • Antifungals: Specifically; fluconazole (Diflucan), itraconazole ( Sporanox, Tolsura), ketoconazole, and voriconazole (Vfend);
  • Human immunodeficiency virus (HIV) medications: Specifically; indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Viekira, in Paxlovid), and saquinavir (Invirase), and tipranavir (Aptivus). 
  • Antibiotics: Specifically; clarithromycin, ciprofloxacin (Cipro), cyclosporine (Gengraf, Neoral, Sandimmune), erythromycin (E.E.S., Eryc, Eryped, Ery-tab), and rifampin (Rifadin, Rimactane, in Rifamate and Rifater).
  • Other Medications: Specifically; aprepitant (Emend), conivaptan (Vaprisol), crizotinib (Xalkori), diltiazem (Cardizem, Cartia, Taztia, Tiazac), dronedarone (Multaq), fluvoxamine, imatinib (Gleevec), and verapamil (Calan, Verelan, in Tarka).
  • Nurtec is known to have drug interactions with Strong or Moderate CYP3A4 Inhibitors, Strong or Moderate CYP3A Inducers, and  Potent Inhibitors of P-gp.

    Your doctor may need to change the doses of your medications, how often or if you should take Nurtec ODT, or monitor you carefully for side effects. Many other medications may also interact with Nurtec ODT so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

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