Nurtec hair loss: Why it may happen

In this article:

• Does Nurtec cause hair loss?
• Other Nurtec side effects
• How to manage Nurtec side effects and related hair loss
• Nurtec alternatives

In this article

• Does Nurtec cause hair loss?
• Other Nurtec side effects
• How to manage Nurtec side effects and related hair loss
• Nurtec alternatives

Nurtec ODT (orally disintegrating tablet) is a brand-name prescription drug used for migraine prevention and the treatment of acute migraine headaches. Rimegepant, the active ingredient in Nurtec, works by blocking calcitonin gene-related peptide (CGRP) receptors, stopping the domino effect of inflammation and pain that characterizes a migraine headache. 

Nurtec is a safe, effective migraine medication, but it’s not without side effects. Abdominal pain and nausea are the most common ones. The Food and Drug Administration (FDA) does not list hair loss as a side effect of Nurtec, but some people have reported hair loss or thinning while taking this drug. So, does Nurtec cause hair loss? Not directly. Here’s what you should know about why you might experience hair loss on Nurtec and what to do about it.

Does Nurtec cause hair loss?

The short answer is no. There’s no proof that Nurtec directly causes hair loss, medically known as alopecia, and it’s not a confirmed side effect. However, there have been reports of hair loss while on this drug, and it might have something to do with how Nurtec blocks CGRP receptors, according to Lauren R. Natbony, MD, medical director of Integrative Headache Medicine of New York.

“Anecdotally, I will say that patients have reported hair loss on some of the CGRP monoclonal antibodies,” Dr. Natbony says. However, she says those patients were on other CGRP blockers, not Nurtec.

As of June 2024, the FDA Adverse Event Reporting System (FAERS) Public Dashboard shows 57 patient or healthcare provider reports of hair loss (alopecia) during Nurtec ODT use. To put that number into perspective, reports of alopecia made up only 0.75% of submissions related to Nurtec. In comparison, 41% of submissions about Nurtec reported that the drug was ineffective, while nearly 10% reported nausea as an adverse reaction.

A review of the FAERS cases published in Cephalalgia, the official journal of the International Headache Society, suggests that “disruptions in the microvascular circulation” might have contributed to the reported hair loss. When CGRP blockers prevent rapid dilation of blood vessels in the head (a key cause of migraine pain), perhaps the disrupted circulation might also reduce blood flow to hair follicles. Indeed, Dr. Natbony says it’s possible that CGRP plays a role in promoting hair growth. “By blocking it, it is plausible that hair loss may occur,” she says.

In the end, there have not been enough controlled studies to definitively link Nurtec use to hair loss. More research is needed to understand Nurtec and other CGRP blockers’ role in hair growth or loss.

Other Nurtec side effects

Nurtec is not known for having a long list of side effects. In clinical trials reported on the drug label, the most commonly reported side effects were nausea and abdominal pain. Both of these occurred in about 2% of participants, with nausea being slightly more common than stomach pain or indigestion. 

Nurtec’s most serious side effects are a skin rash and trouble breathing, which occurred in less than 1% of participants in the clinical trial. These adverse events were linked to allergic reactions. Although these are relatively mild signs of an allergic reaction, any drug allergy has the potential to be serious. If you experience a skin rash or difficulty breathing after taking Nurtec, it’s a good idea to tell your healthcare provider right away.

RELATED: Nurtec side effects

How to manage Nurtec side effects and related hair loss

Indirectly, nausea experienced while taking Nurtec may be the root cause of hair loss, especially if nausea is affecting dietary choices. “When someone is experiencing hair loss, it’s important to consider their diet,” says Vesta Batchelder, LDN, RD, a registered dietitian who works with the bariatric community in New Orleans, Louisiana. She says nutritional deficiencies to look for include:

• Folate
• Iron
• Vitamin B1
• Vitamin B6

“Inadequate amino acids such as histidine, leucine, and valine promote alopecia, and a deficiency of omega-3 fatty acid leads to hair loss,” Batchelder adds. 

Bottom line: If you are eating fewer calories or avoiding certain foods due to nausea or abdominal discomfort while on Nurtec, consider asking your healthcare provider to run tests to determine if you are deficient in an essential nutrient. In the meantime, try to eat more of these whole foods full of hair-nourishing nutrients:

• Pumpkin seeds
• Chia seeds
• Salmon
• Lean meats, such as chicken and white turkey meat

If diet isn’t the cause of hair loss while taking Nurtec, it could be a decrease in blood flow to hair follicles. Research suggests that scalp massages might help promote hair growth, though more controlled studies are needed. 

Finally, Batchelder says pumpkin seed oil might help treat hair loss, regardless of the cause. In a study of 76 men with hair loss, those who took 400 milligrams (mg) of pumpkin seed oil daily for 24 weeks experienced a 40% increase in hair count. In comparison, the group who took a placebo reported a 10% increase. 

To avoid negative drug-food or drug-supplement interactions, consult your healthcare provider before starting any vitamins or over-the-counter hair loss treatments while on Nurtec. 

Nurtec alternatives

Rimegepant is not the only drug that is FDA approved for the prevention of migraines and the acute treatment of migraine attacks. The most common Nurtec alternatives are other CGRP inhibitors, such as:

• Quilipta (atogepant)
• Ajovy (fremanezumab)
• Ubrelvy (ubrogepant)
• Aimovig (erenumab)

RELATED: Nurtec vs. Aimovig │Qulipta vs. Nurtec │Ubrelvy vs. Nurtec

Like Nurtec, Quilipta and other CGRP inhibitors did not cause hair loss in clinical trials. However, the likelihood of hair loss from Quilipta or other drugs in the same class could be similar to the probability of hair loss from Nurtec since they all affect CGRP. 

Other medications used for the prevention of migraines or acute treatment of migraine attacks include Topamax (topiramate), valproic acid, propranolol, and tricyclic antidepressants. However, Dr. Natbony says that, to varying degrees, all of these medications are associated with hair loss as a possible side effect. Additionally, Topamax has been linked to hair loss. 

Triptans, such as Imitrex (sumatriptan) and Zomig (zolmitriptan), are also commonly prescribed for the treatment of acute migraine headaches. While hair loss is not a common side effect of triptans, the possibility can’t be ruled out.

So, which Nurtec alternatives won’t cause hair loss? “There are no pharmaceutical-grade preventive medications that I can say are ‘definitely not’ associated with hair loss,” Dr. Natbony says. “However, Botox injections for chronic migraines are not known to be associated with hair loss. Likewise, neuromodulation devices are unlikely to have any impact on hair health.”

It’s important to tell your neurologist or other healthcare professional if your side effects are significant and negatively affecting your quality of life. Likewise, if hair loss is the only side effect you experience on Nurtec, it’s important to investigate whether the drug is to blame. 

“For patients who respond well to Nurtec, I recommend first addressing any coexisting causes of hair loss, such as vitamin deficiencies, medical conditions, and hormonal factors,” Dr. Natbony says.