Migraines can grind your day to a halt. They may leave you nauseated, cause vision problems, and make you more sensitive to lights and noise for hours or even days.
Your doctor may prescribe you Qulipta, which is a brand name for a drug called atogepant that can actually stop migraines from coming on. There’s no generic version of it yet.
Here are some key things to know about this medication.
Atogepant (Qulipta) Prevents, but Does Not Stop, Migraines
This drug is designed to prevent a migraine. But atogepant doesn’t work if your headache has already started. Atogepant blocks the action of a protein called calcitonin gene-related peptide, or CGRP. When it’s released in large amounts, CGRP causes pain in nerve endings around your eyes, the middle part of your face, and jaw. By blocking this protein, atogepant reduces the chances of migraines happening.
Clinical trials showed that after 12 weeks of taking 60 milligrams of atogepant, 6 out of 10 people had their number of migraine days cut by at least half. For some, their migraines were gone completely. But most people who take atogepant will still have some migraines.
If you feel a migraine coming on, you’ll need another migraine drug to stop your headache at this point.
Atogepant (Qulipta) Doesn’t Treat Occasional or Chronic Migraines
Atogepant is prescribed for people who have “episodic” migraines. That means 14 or fewer headaches a month.
If you only get them once a week or less, your doctor may recommend what are called “abortive” medicines that stop migraines as soon as you start to feel them. But if you take abortive migraine medicines too often, you may end up having more headaches. That’s why your doctor may prescribe you a preventive migraine drug like atogepant.
If you have 15 or more migraines a month, you’d be considered to have “chronic” migraines. The FDA has not yet approved atogepant as a treatment for chronic migraines.
You Can Combine Atogepant (Qulipta) With Another Migraine Drug
While atogepant works to prevent migraines, you may still have them while taking the drug. Your doctor will usually allow you to also take an abortive migraine drug, like ubrogepant (Ubrelvy) or rimegepant (Nurtec), to stop a migraine once it starts.
Your Insurance May Not Cover Atogepant (Qulipta) Right Away
Atogepant has only been available to prevent migraines since October of 2021. The list price for a 30-day dose is $1,040. Your employer’s insurance or Medicare may cover some or all of atogepant’s cost.
But before the coverage kicks in, you may have to show that you’ve tried at least two older types of migraine treatments, such as beta-blockers, tricyclic antidepressants or anti-seizure medicines. If these don’t work or you can’t handle the side effects, insurers are more likely to cover atogepant.
You Take Atogepant (Qulipta) Once a Day as a Pill
Migraine medicines come in different forms. Some are nasal sprays that are fast-acting but can irritate your nose. Others are injected so that the medicine can still work even if you vomit from your migraine. Those can be a hassle to take, especially if you’re afraid of needles.
Others are pills, like atogepant. You need to take it every day, whether you’re having a migraine or not. Store it at room temperature to keep its effectiveness.
Atogepant (Qulipta) May Cause Nausea, Constipation, or Fatigue
These are the most common side effects of atogepant. The drug helps block the pain-causing CGRP protein in your brain. But atogepant also blocks the CGRP pain receptors in your stomach, gut, and colon, which can lead to side effects such as constipation and nausea.
In clinical trials, 6% of people taking atogepant reported feeling constipated, or trouble with pooping. Another 5%-9% felt nausea, and 4%-6% said atogepant made them feel tired. The drug also can lower your appetite and lead to weight loss.
Atogepant (Qulipta) May Take a Few Weeks to Start Working
Your doctor may want to wait at least 1 week or up to 2 months after you start atogepant to see how well it’s working and whether you’re having side effects.
The longer you’ve been on atogepant, the more your body adjusts to it. But if your side effects don’t go away or continue to bother you, your doctor may need to adjust your dose.
Atogepant (Qulipta) Isn’t Safe if You Are Pregnant or Breastfeeding
People who are pregnant or plan to become pregnant shouldn’t take atogepant because it may not be safe for unborn babies.
If you breastfeed or plan to breastfeed, ask your doctor if atogepant is right for you. There isn’t enough research to know whether the drug passes through breast milk, and if it might affect your baby.
Kidney or Liver Problems May Affect Your Dose for Atogepant (Qulipta)
Atogepant comes in three strengths: 10 milligrams, 30 milligrams, and 60 milligrams.
Your doctor will most likely start you out at a 60-milligram dose of atogepant if you have no kidney or liver problems and don’t take any other medications.
But you may need a lower dose of atogepant if your kidney or liver is not working right. Your doctor also may adjust your dose depending on whether you take certain other medications or supplements. They include:
- Ketoconazole or itraconazole
- Cyclosporine
- Clarithromycin
- Rifampin
- Carbamazepine
- Phenytoin
- St. John’s wort
- Efavirenz
- Etravirine
The Long-Term Safety of Atogepant (Qulipta) Is Still Unknown
This medication is very new, so it’s too early to know about long-term effects of taking atogepant. Safety studies are going on now. But researchers who followed people taking it for 1 year did not find any significant risks.
