Rimegepant: A Review in the Acute Treatment and Preventive Treatment of Migraine

Rimegepant [Nurtec® ODT (USA); Vydura® (EU)] is a calcitonin gene-related peptide (CGRP) receptor antagonist approved for the acute treatment of migraine with or without aura in adults, and for the preventive treatment of episodic migraine in adults. Rimegepant is available as an orally disintegrating tablet (ODT), which offers convenience and a potentially faster response time than the conventional tablet formulation. In pivotal phase III trials, rimegepant was more effective than placebo at relieving pain and the most bothersome symptom when taken as needed for the acute treatment of migraine. Rimegepant was also more effective than placebo at reducing the number of monthly migraine days when taken every other day for the preventive treatment of migraine. The beneficial effects of rimegepant in reducing migraine frequency and improving quality of life were maintained over the longer term (up to 52 weeks). Rimegepant was generally well tolerated, with no evidence of hepatotoxicity or cardiovascular toxicity in clinical trials. As the first dual agent approved for both treatment and prevention of migraine, rimegepant represents a useful option for the management of migraine in adults. Migraine is a type of headache that causes severe throbbing pain, usually on one side of the head. Bothersome symptoms that may occur during a migraine include nausea, vomiting and sensitivity to light and sound. Medications for migraine are aimed at stopping symptoms (acute treatment) and/or reducing the frequency of future attacks (preventive treatment). Calcitonin gene-related peptide (CGRP) is a protein that is released during migraine attacks, causing inflammation and activation of other pathophysiological processes responsible for pain. Rimegepant [Nurtec® ODT (USA); Vydura® (EU)] is an oral medication that works by blocking the CGRP receptors. A convenient quick-dissolve tablet formulation is available that can be placed on or under the tongue and swallowed without water. Rimegepant relieves pain and bothersome symptoms when taken as needed for a single migraine attack, and reduces the number of migraine days per month when taken every other day to prevent migraine. Rimegepant is generally well tolerated. As the first medication approved to both treat acute migraine attacks and help prevent future attacks, rimegepant represents a useful treatment option for patients with migraine.