Classes
DAE Class; Rx
Common Brand Names; Nurtec ODT
- Antimigraine Agents;
- CGRP Receptor Antagonists
Description
Calcitonin gene-related peptide (CGRP) receptor antagonist; binds to CGRP receptor, which is thought to be causally involved in migraine pathophysiology
Indications
Indicated for acute treatment of migraine with or without aura
Indicated for preventive treatment of episodic migraine
Contraindications
History of hypersensitivity to rimegepant; delayed serious hypersensitivity reported
Adverse Effects
1-10%
Nausea (2%)
<1%
Hypersensitivity, including dyspnea and severe rash
Warnings
Hypersensitivity
- Hypersensitivity reactions, including dyspnea and rash, reported
- Reactions can occur days after administration, and delayed serious hypersensitivity has occurred
- If a hypersensitivity reaction occurs, discontinue rimegepant and initiate appropriate therapy
Drug interaction overview
Strong or moderate CYP3A4 inhibitors
- Strong CYP3A4 inhibitors: Avoid coadministration; coadministration results in significant increase in rimegepant exposure
- Moderate CYP3A4 inhibitors: If coadministered, avoid another dose of rimegepant within 48 hr
Strong or moderate CYP3A inducers
- Avoid coadministration
- Coadministration may result in significant reduction in rimegepant exposure and loss of efficacy
Inhibitors of P-gp or BCRP
- Avoid coadministration
- Coadministration may result in significant increase in rimegepant exposure
Pregnancy and Lactation
Pregnancy
Data are not available regarding the developmental risk associated with use in pregnant women
Lactation
Results from a lactation study established a relative infant dose (<1% of maternal weight-adjusted dose) and milk-to-plasma ratio was 0.2
There are no data on effects of rimegepant on breastfed infants or on milk production
Maximum Dosage
Migraine Treatment
Indicated for acute treatment of migraine with or without aura
75 mg PO as needed
Not to exceed 75 mg per 24-hr period
Safety of >18 doses/30 days has not been established
Migraine Prevention
Indicated for preventive treatment of episodic migraine
75 mg PO every other day
Dosage Modifications
CYP3A4 inhibitors
- Strong: Avoid coadministration
- Moderate: Avoid another dose of rimegepant within 48 hr when coadministered
CYP3A4 inducers
- Strong or moderate: Avoid coadministration
P-gp or BCRP inhibitors
- Avoid coadministration
Renal impairment
- Mild, moderate, or severe (CrCl ≥15 mL/min): No dosage adjustment required
- End-stage renal disease (CrCl <15 mL/min): Avoid; not studied
Hepatic impairment
- Mild or moderate (Child-Pugh A or B): No dosage adjustment required
- Severe: Avoid
How supplied
Rimegepant
oral disintegrating tablet
- 75mg