If you get migraines, your doctor might prescribe rimegepant (Nurtec ODT) as part of your treatment plan. Here are some frequently asked questions about rimegepant.
What Is Rimegepant (Nurtec ODT)?
Rimegepant is a fast-acting oral migraine medication (the type you take by mouth). It belongs to a class of drugs called calcitonin gene-related peptide receptor antagonists.
The drug is unique because it can both stop headache pain during a migraine attack and help prevent migraines in the future. It’s for people who get less than 15 headaches a month. You can take it whether or not your headaches come with auras, which are sensory disturbances like vision or speech problems.
It’s sold under the brand name Nurtec ODT. No generic versions are available.
How Do You Take Rimegepant (Nurtec ODT)?
To treat a headache, you take this medication as you need it. It’s an orally dissolvable tablet. When you put it on your tongue, it breaks down in a few seconds.
You can also place it under your tongue to dissolve it. You don’t have to swallow it or take it with water. Don’t chew, break, or crush it.
Use dry hands to take it out of the foil packaging. And take it soon after you open it.
According to the drug label, it’s best to limit yourself to 18 doses per month. Don’t take more than 1 tablet every 24 hours. If you use the drug only to prevent future headaches, take 1 tablet every other day.
Before you skip a dose, stop taking the medication, or take more than the prescribed amount, always check with your doctor.
How Does Rimegepant (Nurtec ODT) Work?
People who get migraines have higher levels of a protein called calcitonin gene‑related peptide (CGRP) in their brains. This protein attaches itself to pain receptors (proteins involved in communication between cells) in your brain and activates them. It also widens (dilates) blood vessels. These things can trigger a migraine.
Rimegepant keeps the CGRP receptors from being activated. That helps prevent future migraine attacks.
During a migraine, this same action relieves pain by cutting off pain signals, reducing inflammation, and stopping swelling in your blood vessels.
How Fast Does Rimegepant (Nurtec ODT) Work?
Since the medication dissolves on your tongue in a few seconds, it enters your bloodstream quickly.
When you take it during an attack, symptoms like pain, nausea, and sensitivity to light and sound should improve or go away within 2 hours.
Studies have also shown that many people get complete relief in as little as an hour. The drug’s benefits can last up to 48 hours.
In terms of prevention, studies indicate that most people who start rimegepant see a sharp drop in the number of headaches they get after 9-12 weeks. Some people start having fewer migraines in just one week.
The medication is only available in a 75-milligram dose.
What Are the Potential Side Effects of Rimegepant (Nurtec ODT)?
Like any drug, rimegepant can cause side effects. But not everyone gets them, and most who do have only minor issues. Common side effects include:
- Nausea
- Indigestion
- Stomach pain
A more serious side effect is an allergic reaction to the drug or any of its ingredients. This is rare, but could lead to:
- Itching
- Rash
- Hives
- Swelling of the face, mouth, or tongue
- Difficulty breathing
- Difficulty swallowing
In some people, an allergic reaction might not happen until a few days after you take the drug. Get medical help right away if you have trouble breathing or swallowing, or notice swelling of your face, mouth, tongue, or throat.
If you have any side effects that bother you or don’t go away, tell your doctor. You can also report side effects to the FDA at 800 FDA-1088 (800-332-1088).
Can You Take Rimegepant (Nurtec ODT) With Other Medications?
If you take rimegepant to stop headaches, you can take it with other preventative migraine medications. But since it can also prevent episodes, check with your doctor about overlapping medications. They’ll adjust your treatment plan if necessary.
Rimegepant can interact with many types of drugs. In some cases, this can cause harmful side effects. Interactions can also weaken Rimegepant’s effects on your migraine symptoms.
Among the medications that can interact with rimegepant are:
- Some antibiotics, including clarithromycin (Biaxin), ciprofloxacin (Cipro), erythromycin, rifampin (Rifadin, Rimactane)
- Antifungal medications like fluconazole (Diflucan), itraconazole (Onmel, Sporanox), ketoconazole, and voriconazole (Vfend)
- The blood pressure medicines diltiazem (Cardizem, Cartia, Taztia, Tiazac) and verapamil (Calan, Verelan)
- Cancer treatments like crizotinib (Xalkori) and imatinib (Gleevec)
- Aprepitant (Emend), an anti-nausea drug
- Conivaptan (Vaprisol), used to treat low sodium levels
- Cyclosporine (Gengraf, Neoral, Sandimmune), which you might get to treat an immune disorder or after an organ transplant
- Dronedarone (Multaq), which treats irregular heart rhythms
- Fluvoxamine (Luvox) used to treat obsessive-compulsive disorder (OCD)
- Some drugs used to treat HIV, including indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Viekira), saquinavir (Invirase), and tipranavir (Aptivus)
Rimegepant can also interact with chemicals found in grapefruits and grapefruit juice, so avoid them when you take this drug.
Who Shouldn’t Take Rimegepant (Nurtec ODT)?
Don’t take rimegepant if you:
- Have serious liver problems
- Have end-stage kidney disease
- Are allergic to rimegepant or any of its ingredients
- Are pregnant
- Are breastfeeding
If you’re planning to get pregnant or breastfeed, let your doctor know ahead of time. If you get pregnant while taking it, tell your doctor right away. We need more research to know whether rimegepant is safe in these situations.
Rimegepant hasn’t been approved for use in children.
What Should I Tell My Doctor Before I Take Rimegepant (Nurtec PDT)?
Before you start taking rimegepant, make sure your doctor knows about:
- All the drugs you take, including prescription and over-the-counter drugs
- Any vitamins, herbs, or dietary supplements you use
- Any current health problems you may have
- Your medical history, especially if you’ve ever had liver or kidney problems
- Any allergies you may have to drugs or food
You might be prescribed rimegepant for migraine treatment or prevention by a primary care doctor, neurologist, or headache specialist.
If you see any other health care providers, tell them you take rimegepant for migraine treatment or prevention. They may need to adjust or switch medications to avoid possible interactions.
How Much Does Rimegepant (Nurtec ODT) Cost?
The full retail price for a pack of 8 tablets can be more than $1,000, according to GoodRX. But your out-of-pocket cost will probably be considerably less. How much you pay depends on whether you have health insurance for prescription drugs and what type.
If you have private health insurance, you might be eligible for the drug manufacturer’s copay card. In some cases, you might get the drug at no cost when you use this discount program. Not all pharmacies accept the copay card.
You can’t use the copay card if you’re enrolled in a state or federal health insurance program such as Medicare, Medicaid, TRICARE, or Veterans Affairs health care. Ask your doctor if you’re eligible.
