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