Rimegepant Orally Disintegrating Tablet (Nurtec ODT)

The Food and Drug Administration has approved the second oral, non-peptide, small molecule, calcitonin gene-related peptide (CGRP) receptor antagonist, following ubrogepant, for acute migraine. Rimegepant is the first quick-dissolving tablet approved for this indication. It received a priority review and is marketed as Nurtec ODT.

INDICATIONS

Rimegepant should be prescribed to treat acute migraine with or without aura in adults.¹

DOSAGE

The recommended dose is 75 mg placed on or under the tongue as needed.¹ No water is needed. The maximum dose is one tablet in a 24-hour period. The safety of treating more than 15 migraines that occur in a 30-day period has not been established.¹ Rimegepant is available as 75 mg orally disintegrating tablets (ODT).

POTENTIAL ADVANTAGES

Rimegepant is a quick-dissolving tablet that does not require water for administration. It may onset faster vs. ubrogepant. Rimegepant also has a long elimination half-life (approximately 11 hours) vs. five to seven hours for ubrogepant.^1,2 This may contribute to a longer duration of action.

POTENTIAL DISADVANTAGES

Rimegepant is a substrate of CYP3A4 as well as transporters P-gp and breast cancer-resistant protein (BCRP); thus, avoid using with strong CYP3A4 inhibitors, strong and moderate CYP3A4 inducers, and inhibitors of...