Rimegepant

What is Rimegepant

Rimegepant is an oral calcitonin gene-related peptide (CGRP) receptor antagonist indicated for the acute treatment of migraine with or without aura in adults.

Rimegepant is not indicated for the preventative treatment of migraine. In a randomized, double-blind, placebo-controlled trial, significantly more patients were pain free at 2 hours post-dose with rimegepant 75 mg (21.2%) compared to placebo (10.9%).

Absence of the most bothersome migraine-associated symptom (i.e., phonophobia, photophobia, or nausea) at 2 hours post-dose was also significantly higher in patients treated with rimegepant (35.1%) compared to placebo (26.8%).

The safety of rimegepant in treating more than 15 migraines in a 30-day period has not been established.

Rimegepant is associated with hypersensitivity reactions, including dyspnea and rash. Hypersensitivity reactions can occur days after rimegepant administration, and delayed serious hypersensitivity has occurred.

Coadministration of certain other drugs may need to be avoided or dosage adjustments may be necessary.

Brand Name

NURTEC ODT

Indications

• migraine

Side Effects

• dyspnea
• nausea
• rash

In a randomized, double-blind, placebo-controlled trial (n = 682), nausea occurred in 2% of patients who received rimegepant compared to 0.4% of patients who received placebo.

Hypersensitivity reactions, including dyspnea and severe rash, occurred in less than 1% of patients who received rimegepant during clinical trials.

Hypersensitivity reactions can occur days after rimegepant administration, and delayed serious hypersensitivity has occurred. If a hypersensitivity reaction occurs, institute appropriate therapy and discontinue rimegepant.

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• breast-feeding
• dialysis
• hepatic disease
• pregnancy
• renal disease
• renal failure

Interactions

• Acalabrutinib
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Amiodarone
• Amobarbital
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Apalutamide
• Aprepitant, Fosaprepitant
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Atazanavir
• Atazanavir; Cobicistat
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bexarotene
• Bosentan
• Brigatinib
• Butabarbital
• Cabozantinib
• Capmatinib
• Carbamazepine
• Carvedilol
• Cenobamate
• Ceritinib
• Chloramphenicol
• Ciprofloxacin
• Clarithromycin
• Cobicistat
• Conivaptan
• Crizotinib
• Cyclosporine
• Dabrafenib
• Daclatasvir
• Danazol
• Darolutamide
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Delavirdine
• Dexamethasone
• Dextromethorphan; Quinidine
• Diltiazem
• Dronedarone
• Duvelisib
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Elbasvir; Grazoprevir
• Elexacaftor; tezacaftor; ivacaftor
• Eliglustat
• Eltrombopag
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Enzalutamide
• Erythromycin
• Erythromycin; Sulfisoxazole
• Eslicarbazepine
• Etravirine
• Fedratinib
• Flibanserin
• Fluconazole
• Fluvoxamine
• Fosamprenavir
• Fosphenytoin
• Fostamatinib
• Glecaprevir; Pibrentasvir
• grapefruit juice
• Ibrutinib
• Idelalisib
• Imatinib
• Indinavir
• Isavuconazonium
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Istradefylline
• Itraconazole
• Ivacaftor
• Ketoconazole
• Lapatinib
• Lasmiditan
• Ledipasvir; Sofosbuvir
• Lefamulin
• Leflunomide
• Letermovir
• Lomitapide
• Lopinavir; Ritonavir
• Lorlatinib
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Mefloquine
• Methohexital
• Mifepristone
• Mitotane
• Modafinil
• Nafcillin
• Nefazodone
• Nelfinavir
• Neratinib
• Netupitant, Fosnetupitant; Palonosetron
• Nevirapine
• Nilotinib
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Osimertinib
• Phenobarbital
• Phenytoin
• Ponatinib
• Posaconazole
• Primidone
• Propafenone
• Quinidine
• Quinine
• Ranolazine
• Regorafenib
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
• Rifampin
• Rifapentine
• Rifaximin
• Ritonavir
• Rolapitant
• Safinamide
• Sapropterin
• Saquinavir
• Sarecycline
• Secobarbital
• Sirolimus
• Sofosbuvir; Velpatasvir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Sorafenib
• St. John’s Wort, Hypericum perforatum
• Sulfasalazine
• Tacrolimus
• Tafamidis
• Tedizolid
• Telithromycin
• Temsirolimus
• Teriflunomide
• Tezacaftor; Ivacaftor
• Ticagrelor
• Tolvaptan
• Trandolapril; Verapamil
• Tucatinib
• Vemurafenib
• Venetoclax
• Verapamil
• Voriconazole
• Zonisamide