Qulipta is a daily pill designed to prevent episodic migraines, which is when you get up to 14 migraines a month. It’s the brand name for the drug called atogepant (a-TOE’-je-pant).
Atogepant blocks the actions of a protein called calcitonin gene-related peptide, or CGRP, in the brain. CGRP can add to the feeling of a migraine. When large amounts of CGRP are released, it agitates the nerves in your head and face that can lead to migraine pain.
But CGRP also affects your gut, including how well you empty your colon. So a drug that blocks this protein can cause problems with your digestion.
Here are the side effects you can expect from atogepant and how to handle them.
Most Common Side Effects of Atogepant (Qulipta)
They are usually mild, and about 1 in 10 people in clinical trials for the drug reported these side effects. The most common side effects are:
- Nausea
- Constipation
- Fatigue
- Lowered appetite.
These symptoms may stem from the fact that atogepant stops your body from absorbing the protein CGRP.
Atogepant’s side effects may improve or go away on their own as your body adjusts to the medication.
You can also try the following:
- Take your atogepant pill with some food or a light snack. Nausea makes it hard to stomach large meals. Try lighter meals more often throughout the day.
- Stay hydrated. Atogepant may make you feel tired, and dehydration can make it worse. Drink lots of water to combat sluggishness. It’s OK to drink coffee. Unlike other migraine drugs, atogepant doesn’t have caffeine as an active ingredient. So a cup of coffee won’t interfere with your treatment. But drink it in moderation. Caffeine can be another headache trigger.
- Change your diet. Leafy greens can help with constipation, which is when you have trouble pooping. High-fiber foods such as oatmeal also may help.
- Take atogepant before bed. If you sleep through the night, the nausea side effect of atogepant may wear off by the time you eat your first meal the next day.
Less Common Side Effects of Atogepant (Qulipta)
Research shows that this drug may lead to weight loss. In clinical studies, more people who took atogepant lost at least 7% of their body weight, compared to those who took a placebo. For someone who started at 175 pounds, that’s a drop of more than 12 pounds.
Weight loss from atogepant also appears to increase over time, especially if you’re on a 60-milligram dose.
Weight loss may be an issue if you’re trying to put on pounds or keep your weight stable. It isn’t clear if the nausea and lowered appetite from atogepant causes the weight loss, or if it’s something else. See if eating smaller, lighter meals helps with your nausea. Or ask your doctor what else to try.
Serious Side Effects of Atogepant (Qulipta)
It’s rare, but more serious issues sometimes come up for people taking atogepant.
Liver function. Some people taking part in clinical trials of atogepant had increased levels of certain liver enzymes. That points to possible damage to your liver. That may stem from taking certain other medicines and supplements along with atogepant, or having an existing illness like fatty liver disease or hepatitis.
Talk to your doctor about all the medicines you take, and whether you have liver conditions. You may need to take a lower dose or stop atogepant altogether. People in the clinical trials did not have serious injury to their livers, and enzyme levels went back to normal 8 weeks after they stopped the drug.
Kidney function. Atogepant has not been shown to cause problems for people with mild or moderate kidney problems. But if you have serious kidney disease, your body may not be able to properly flush out the drug. You shouldn’t take more than 10 milligrams of atogepant daily.
Allergic reaction. You should also talk to your doctor if you’re allergic to any of the ingredients in atogepant, or if you notice an allergic reaction. The drug contains:
- The active ingredient atogepant, which blocks CGRP to prevent migraines
- The inactive ingredients silicon dioxide, croscarmellose sodium, mannitol, microcrystalline cellulose, copovidone, sodium chloride, sodium stearyl fumarate, and vitamin E polyethylene glycol succinate
Signs of an allergic reaction include:
- A rash or hives on the skin
- Itching
- Wheezing or a hard time breathing
- Swelling of the face or throat
If you see signs that you’re allergic to atogepant, call 911 for emergency care or contact your doctor right away.
What Should I Do if the Side Effects of Atogepant (Qulipta) Don’t Get Better?
Give it some time. But if you’ve taken steps to manage your nausea, constipation, and fatigue and still don’t see signs of improvement, talk to your doctor. You may need to lower your dose of atogepant.
