Neurology Book



Aka: Gepant, Ubrogepant, Ubrelvy, Rimegepant, Nurtec
  1. See Also
    1. Calcitonin Gene-Related Peptide Blocker
  2. Indications
    1. Acute Migraine Headache
      1. Third-line agent in acute Migraine Headaches refractory to NSAIDS and Triptans
  3. Mechanism
    1. Blocks CalcitoninGene-Related Peptide (CGRP)
      1. CGRP is a vasodilator and pain sensitizer
  4. Preparations
    1. Ubrogepant (Ubrelvy)
      1. Costs $85 per tablet (contrast with 70 cents per Sumatriptan tablet)
      2. May be repeated 2 hours after first dose if inadequate effect
    2. Rimegepant (Nurtec)
      1. Dissolving oral tablet: 75 mg taken as single dose (maximum 75 mg/day)
  5. Efficacy
    1. NNT 10 for one patient to be pain free at 2 hours
      1. Contrast with NNT 5 for Sumatriptan
  6. Adverse Effects
    1. Nausea
  7. Drug Interactions
    1. CYP3A4 Substrate (Rimegepant)
      1. Drugs levels may be increased by strong CYP3A4 inhibitors
  8. References
    1. (2020) Presc Lett 27(3): 13

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