Nurtec ODT (Rimegepant)

Nurtec ODT (rimegepant) is an orally disintegrating tablet that can be used for both acute treatment and prevention of migraine in adults. It's a CGRP receptor antagonist with the unique ability to serve dual purposes.

How It Works

CGRP (calcitonin gene-related peptide) is central to migraine:

• Levels increase during migraine attacks
• Causes inflammation and pain sensitization
• Blocking it prevents and relieves migraine

Rimegepant:

• Blocks CGRP receptors
• Reduces migraine-related inflammation
• Works for both acute attacks and prevention

Common Uses

Acute Treatment

• Treatment of migraine attacks as they occur
• Migraine with or without aura
• Alternative when triptans contraindicated or don't work

Preventive Treatment

• Reduce frequency of migraine attacks
• For patients with frequent migraines
• Alternative to daily preventive medications

How to Use

For Acute Treatment

• Dose: 75 mg at migraine onset
• Maximum: One dose per day (can use up to 18 days/month)
• Technique: Place on tongue; dissolves without water

For Prevention

• Dose: 75 mg every other day
• Take consistently for prevention benefit
• Can also treat breakthrough migraines on other days

Administration

• Remove tablet from blister with dry hands
• Place on tongue
• Tablet dissolves within seconds
• No water needed (but can take with water if preferred)
• Can take with or without food

What to Expect

Acute Use

• Relief typically begins within hours
• Addresses pain and associated symptoms
• No cardiovascular restrictions

Prevention

• Reduces monthly migraine days
• May take weeks to see full benefit
• Provides flexibility (acute use on off-days)

Side Effects

Common

• Nausea
• Abdominal pain/indigestion

Less Common

• Hypersensitivity reactions (rare)

Generally Well-Tolerated

• Lower side effect burden than many preventives
• No cardiovascular effects
• No triptan-like sensations

Advantages of Nurtec

Dual Use

• Only medication approved for both acute and preventive treatment
• Simplifies regimen for some patients
• Flexibility in dosing

Vs. Triptans

• No blood vessel constriction
• Safe with cardiovascular disease
• Can use with uncontrolled hypertension
• Different mechanism if triptans fail

Orally Disintegrating Tablet

• No water needed
• Good when nausea makes swallowing difficult
• Convenient

Precautions

• Pregnancy: Limited data; discuss with doctor
• Breastfeeding: Unknown excretion in milk
• Severe hepatic impairment: Avoid use
• Drug interactions: Some interactions with certain medications
• Don't exceed recommended doses

Nurtec in the Treatment Landscape

For Acute Treatment

Medication	Class	Delivery
Nurtec	CGRP antagonist	Oral (ODT)
Zavzpret	CGRP antagonist	Nasal spray
Ubrelvy	CGRP antagonist	Oral tablet
Triptans	5-HT agonist	Various

For Prevention

Medication	Class	Dosing
Nurtec	CGRP antagonist	Every other day
Aimovig	CGRP antibody	Monthly injection
Ajovy	CGRP antibody	Monthly injection
Topamax	Anticonvulsant	Daily
Beta-blockers	Various	Daily

Cost and Insurance

• Brand-name medication
• May require prior authorization for prevention
• Often approved more easily for acute use
• Manufacturer savings programs available

Frequently Asked Questions

Can Nurtec be used for both treatment and prevention at the same time?

Yes, that's one of Nurtec's advantages. Take it every other day for prevention, and on off-days you can use it to treat a breakthrough migraine. Don't exceed one dose per day.

How long until I see preventive benefit?

Preventive effects may take several weeks to become apparent. Continue taking as prescribed and track your migraine frequency.

Is Nurtec better than triptans?

They're different. Triptans are effective and well-established. Nurtec offers an alternative mechanism without cardiovascular restrictions. Some patients respond better to one than the other.

Can I take Nurtec if I have heart problems?

Unlike triptans, Nurtec doesn't have cardiovascular contraindications. However, always discuss your complete medical history with your doctor.

What if Nurtec doesn't work for my acute migraine?

You can only take one dose per 24 hours. If Nurtec isn't effective, discuss alternatives with your doctor. Not every medication works for every patient.

Does the ODT really work without water?

Yes, the orally disintegrating tablet dissolves quickly on your tongue. You can take it with water if you prefer, but it's not necessary.