What is Nurtec? Uses, warnings & side effects
Nurtec ODT is an oral calcitonin gene-related peptide (CGRP) receptor antagonist used in the treatment of migraine headaches. It can be used in acute migraines with or without aura and also to prevent episodic migraines. CGRP levels are higher in patients who chronically suffer from migraines. It is partially responsible for pain transmission and vasodilation in smooth muscle, which are key components of the migraine experience. CGRP antagonist, or blocking the CGRP signal, has significant effects in the relief of migraine pain. Early research showed a significant number of patients were pain-free just 2 hours after the dose.
Nurtec ODT is approved for use only in adult patients. It is a 75 mg orally dissolvable tablet (ODT) that melts and is absorbed in the cavity under the tongue. This allows for faster absorption and action, and this is particularly helpful because many times, patients experience nausea with their migraine and have a hard time keeping stomach contents down. It should not be used in patients with impaired liver function, those with end-stage renal disease, and those who are pregnant. You should not take more than 18 doses in a 30-day period as the safety beyond that has not been established. Nurtec ODT should be used if you are not a candidate for therapy with drugs in the triptan class of medications or if you have had an inadequate response to at least 2 different triptan drugs.
Nurtec overview
BRAND NAMES:
Nurtec ODT
Generic Names:
Rimegepant
Uses:
Treatment of acute migraine headaches with or without aura.
Prevention of episodic migraines
Therapeutic Classes:
Antimigraine
Forms:
Dissolving Tablet
How it’s taken:
By mouth (on or under the tongue)
What is Nurtec used for?
Nurtec ODT is used to treat acute migraines and in the prevention of episodic migraines for adults. It is used by patients who have failed other forms of migraine management or have a sensitivity to other classes of drugs like serotonin-receptor agonists (triptans). Nurtec ODT as treatment for an acute migraine is best taken when the first symptoms of an acute migraine appear. Nurtec ODT, as a preventive therapy for episodic migraine, is taken once every other day.
Key takeaways
Take Nurtec ODT for acute migraines as soon as you start to experience symptoms.
Do not remove Nurtec ODT from its packaging until you are immediately ready to take the dose.
Nurtec ODT should be dissolved on or under the tongue. Do not swallow whole or take with water.
You should not take this medication if you are pregnant or breastfeeding unless your doctor determines the benefits outweigh the risk. You should also not take Nurtec ODT if you have severe liver or kidney disease.
Nurtec ODT may not be the first medication your doctor chooses for migraines. Nurtec ODT is typically reserved for use once you have failed other treatment types.
What form(s) does Nurtec come in?
Box
8 disintegrating 75 mg tablets
What are common Nurtec dosages?
Treatment of acute migraine: one 75 mg ODT tablet dissolved on or under the tongue at the onset of the migraine
Prevention of episodic migraines: one 75 mg ODT tablet taken every other day
Nurtec images - What does Nurtec look like?
Nurtec
8 tablets disintegrating box
How to take Nurtec
Store the medicine in the provided sealed blister-pack at room temperature, away from heat, moisture, and direct light.
Your doctor will tell you how much medicine to use. Do not use more than directed.
Use rimegepant only when you have a migraine. This medicine is not used on a regular schedule.
Do not open the blister pack that contains the tablet until you are ready to take it.
Make sure your hands are dry.
Peel back the foil, then remove the tablet from the blister pack. Do not push the tablet through the foil.
Place the tablet on or under your tongue where it will dissolve in seconds.
Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
RELATED: How long does Nurtec take to work?
What to do if you miss a dose of Nurtec
If you are taking Nurtec ODT for the treatment of an acute migraine, take the dose as soon as you can. If symptoms reside before you can access the dose, then you should not dose. If you are taking for prevention every other day, take the dose as soon as you remember. If it is already time for your next dose, do not double up on the dose.
Nurtec contraindications - Who shouldn't take Nurtec?
This medicine is not right for everyone. Do not use it if you have had an allergic reaction to rimegepant.
Nurtec warnings
Call your doctor if your symptoms do not improve or if they get worse.
Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease or liver disease.
Using rimegepant alone or in combination with other migraine medicines for 15 or more days per month may lead to worsening of headache. You may keep a headache diary to record your headache frequency and drug use.
Keep all medicine out of the reach of children. Never share your medicine with anyone.
This medicine should be used only for classic or common migraine headaches. It will not work for any other kind of headache or pain.
Nurtec interactions & what to avoid when taking Nurtec
Some medicines can affect how rimegepant works. Tell your doctor if you are using fluconazole, itraconazole, or rifampin.
Nurtec side effects - How does Nurtec make you feel?
Nurtec ODT does not have a lengthy list of potential side effects. However, some of the side effects can be bothersome and severe when they occur. Abdominal pain and nausea are experienced the most frequently; however, they still only occur in about 2% of patients who take Nurtec ODT. Hypersensitivity, or a severe allergic reaction, is possible and can happen several days after the dose of Nurtec ODT is given. This can make it hard to discern why the symptoms are occurring. If you experience shortness of breath, swelling of your airways, or severe skin changes or reactions, contact your prescriber immediately.
Serious side effects
Trouble breathing
Nausea
Abdominal pain
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Sources:
Nurtec ODT, Pfizer Laboratories package insert (Updated April 2023)
Safety of Rimegepant, an Oral CGRP Receptor Antagonist, Plus CGRP Monoclonal Antibodies for Migraine, Headache Journal (2020)
Rimegepant: A Review in the Acute Treatment and Preventive Treatment of Migraine, CNS Drugs Journal, 2023
Clinical efficacy and safety of rimegepant in the treatment of migraine: a meta-analysis of randomized controlled trials, Frontiers in Neurology, 2023
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