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Qulipta side effects and how to avoid them

Qulipta side effects include constipation, fatigue, dizziness, and more
Ashley Broadwater, writer for SingleCare
By | Updated on Feb. 25, 2025 Medically reviewed by Keith Gardner, R.Ph.
Woman with migraine: Qulipta side effects

Key takeaways

  • Qulipta (atogepant) is a prescription medication approved to prevent both episodic migraine and chronic migraine headaches in adults. While generally safe, it can have adverse effects.

  • The most common possible side effects of Qulipta are nausea, constipation, fatigue, decreased appetite, and dizziness.

  • Serious effects include the following symptoms of an allergic reaction such as skin rash, itching, hives, swelling under the skin, and swelling of the mouth, tongue, or throat, which can make it hard to breathe.

  • Taking the prescribed doses exactly as your healthcare provider tells you, taking with food, taking it before bed to avoid nausea, dizziness, and anxiety are all ways to potentially avoid Qulipta side effects.

In this article:

Qulipta (active drug: atogepant) is a brand-name drug and helpful medicine for some people with migraine headaches; more specifically, it’s approved by the Food and Drug Administration (FDA) as a preventive treatment for migraines, including both episodic migraines and chronic migraines. Qulipta is similar to Nurtec ODT in that both are in the calcitonin gene-related peptide (CGRP) receptor antagonist drug class. 

Clinical studies confirm the benefits of Qulipta as a migraine treatment. For example, a 2023 placebo-controlled trial published in Lancet found that taking 30 mg of atogepant twice daily and 60 mg once daily showed “clinically relevant reductions in [monthly migraine days] across 12 weeks in chronic migraine patients.” 

With that said, it can have side effects.

Common side effects of Qulipta

Nausea, constipation, and fatigue or sleepiness are the most common possible side effects of Qulipta, according to the FDA, and they’re more common in women. Those symptoms (plus decreased appetite) were assessed in clinical trials. The FDA label shared the following information:

Nausea

  • Five percent of 10 mg Qulipta users experienced nausea, as well as 6% of 30 mg users and 9% of 60 mg users. This is compared to the placebo users, in which 3% experienced nausea.

Constipation 

  • Six percent of 10 mg Qulipta users, 6% of 30 mg users, and 8% of 60 mg users experienced constipation. This is compared to 2% of placebo users.

Fatigue or somnolence

  • Four percent of 10 mg Qulipta users, 4% of 30 mg users, and 5% of 60 mg users experienced fatigue or somnolence. This is compared to the placebo users, in which 4% experienced fatigue or somnolence.

Decreased appetite

  • Two percent of 10 mg Qulipta users, 1% of 30 mg users, and 3% of 60 mg users experienced a decreased appetite. This is compared to the placebo users, in which less than 1% experienced a decreased appetite.

Dizziness

  • Two percent of 10 mg Qulipta users experienced dizziness, as well as 2% of 30 mg users and 3% of 60 mg users. This is compared to the placebo users, in which 2% experienced dizziness.

Knowing these adverse reactions are possible with Qulipta is especially important because they’re common to other medications, too. “I had one patient that started with Qulipta and Ozempic at the same time, and because both of the medications share some of the same side effects—nausea and vomiting—I was tricked into thinking it was the Ozempic until I figured it out and it was the Qulipta,” says Hany Demian, MD, a pain management healthcare provider and CEO at BioSpine Institute.

Serious side effects of Qulipta

Qulipta can cause severe side effects, too, such as allergic reactions and anaphylaxis, according to the FDA label. 

Mild symptoms of an allergic reaction include itching, hives, and a small rash. Some people may have symptoms of a serious allergic reaction to Qulipta, which can be life-threatening. Swelling of the face, lips, or tongue and trouble breathing are parts of a serious allergic reaction. These signs constitute a medical emergency, in which the patient should immediately seek medical attention. 

Clinical trial data on these side effects was not included, but real-life consumers have had them (and others). “Most of my patients on Qulipta are able to tolerate the common and mild side effects like nausea, vomiting, [and] constipation,” Dr. Demian says. “Probably one-third to one-fourth of my patients can’t tolerate the more serious side effects like chest pain, allergic reactions, and liver or kidney function elevation.”

How soon do Qulipta side effects start?

“Qulipta side effects are fast and furious,” Dr. Demian says. “They could happen in the first few days of taking it.”

The timing also depends on the specific effect. “Usually, a hypersensitive reaction happens in minutes,” says Noor Yono, MD, a neurologist and the medical director of Premier Neurology and Wellness Center. More common side effects, however, may develop over a few days, she adds.

How long do Qulipta side effects last?

Unfortunately, there’s no quick and easy answer here. “Some side effects will subside in a few days or right after you stop the medication, and some are like an unwanted friend, stubborn and will last for weeks to months,” Dr. Demian says.

Again, it partially depends on the specific symptom. He says low-grade fever, nausea, vomiting, and constipation usually subside, whereas liver enzymes, kidney function, a racing heart rate, and wheezy lung issues can last longer and may become severe.

Put another way: “In regards to the more common side effects, they might last for a period of one to two weeks, but possibly could continue for as long as the medicine is being used if the body does not adjust to this new medication,” Dr. Yono says.

What are the long-term side effects of Qulipta?

Neither doctor has seen or is aware of any long-term side effects of Qulipta. The longest Dr. Demian has seen a side effect last is five to six months.

“But it is dose-dependent,” he adds. “I usually don’t go high on the dose for patients.”

Qulipta drug interactions

Drug interactions for Qulipta include concomitant use of the following: 

  • CYP3A4 inhibitors (such as itraconazole): This combination can cause an increase in exposure of atogepant, according to the FDA.
  • CYP3A4 inducers (such as rifampin): This combination can cause a decrease in exposure of atogepant.
  • OATP inhibitors (such as rifampin): Like CYP3A4 inhibitors, this drug class plus Qulipta can cause an increase in atogepant exposure. 

This list is not comprehensive, which emphasizes the need for patients to seek medical advice and ask questions.

Safety measures while using Qulipta

Qulipta has no contraindications (other than people who are allergic to its ingredients, of course), has no black box warnings, and has not been recalled, according to the FDA. However, there’s insufficient evidence to indicate whether Qulipta is safe and effective for pregnant women, children, or seniors. Additionally, no data is available that indicates if atogepant can get into breast milk. So, these populations should assess their needs and risks with a medical provider and take special care when considering or taking this prescription medicine.

There are set exceptions for people with kidney failure and pregnancy. “With kidney failure, a smaller dose is preferred,” Dr. Yono says. Specifically, the FDA recommends a 10 mg dose for patients with severe renal impairment or end-stage renal disease.

Even people who don’t fit into those categories need to take caution before and during Qulipta use. It’s important to note that Qulipta can exacerbate other medical conditions and issues, namely liver disease or liver problems, kidney disease (which comes before kidney failure) or kidney problems, and heart and lung conditions, according to Dr. Demian. 

Some good news, though, is that Qulipta is not habit-forming and will not cause withdrawal symptoms, according to both doctors.

“That being said, I tend not to stop any medication abruptly, and like to take my time in stopping any medication,” Dr. Demian adds.

There’s no specific information about what a Qulipta overdose could look like, but if you or a loved one take more than prescribed, seek medical help immediately. 

How to avoid Qulipta side effects

Dr. Demian advises the following:

  1. People with liver disease, severe kidney problems, an allergy to a similar medication, severe anxiety, a racing heartbeat, or a severe lung condition should avoid Qulipta entirely.
  2. Take the medication daily; it is not a “take as needed” medicine.
  3. Take Qulipta with food. 
  4. Patients can take Qulipta at any time of day, but it must be at the same time every day. Dr. Demian encourages taking it before bed to avoid nausea, dizziness, and anxiety.

There’s no one way for every person to avoid the risk of side effects, though, so some precautions must be customized to the individual patient. Dr. Yono gives the same example as Dr. Demian: taking the medication at night if it causes nausea.

At the same time, she says, “It is a well-tolerated medication in a majority of cases.”

How to treat side effects of Qulipta

To treat Qulipta’s side effects, a patient first needs to know what they are and how bad they are for them specifically. 

If the effects are mild and tolerable, Dr. Demian suggests adjusting the dose and taking it at bedtime. 

Dr. Yono says more common and short-lived side effects don’t require treatment. If they last longer—like days or weeks—she recommends considering stopping the medication (after talking to a healthcare provider, of course).

If the medicine causes hypersensitivity reactions or other serious side effects, both providers urge people to stop taking the medication completely. 

Bottom line: Is Qulipta safe?

Doctors agree that Qulipta is generally safe—with some nuance. 

For one, it’s probably not the first line of treatment for preventive treatment of episodic migraines. “In my opinion and from my practice (I have one of the largest migraine practices and two centers of excellence for migraine treatment), Qulipta comes after Topamax, Botox, and Aimovag,” Dr. Demian says.

As mentioned above, people with certain medical conditions may want to be especially careful when taking Qulipta, if at all, after discussing it with their healthcare provider.

But otherwise, the safety of Qulipta has been established.

Qulipta without an insurance plan costs about $1,500 for 30, 60 mg tablets. People who have difficulty paying (or just want to save hundreds of dollars) can show the pharmacist a SingleCare prescription discount card and buy the prescription medication for $936.