TM Owner Pfizer / Biohaven
Nurtec ODT 75mg Orally Disintegrating Tablet
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Indications & Clinical Uses
- Nurtec ODT 75 mg orally disintegrating tablets contain rimegepant, a calcitonin gene-related peptide (CGRP) receptor antagonist.
- It is indicated in adults for two related but distinct uses: the acute treatment of migraine with or without aura, taken as needed when an attack starts, and the preventive treatment of episodic migraine, taken every other day to reduce how often attacks occur.
- The same 75 mg tablet strength and dose is used for both purposes, but the dosing schedule differs depending on which use your healthcare provider has prescribed.
- Nurtec ODT is not approved for cluster headache or other headache types.
- It is manufactured and marketed in the United States by Pfizer, following its 2022 acquisition of Biohaven Pharmaceuticals, the company that originally developed rimegepant.
Side Effects
- The most commonly reported side effect of Nurtec ODT is nausea, occurring in about 2% of people taking it for acute treatment of migraine and around 2.7% of people taking it for prevention; stomach pain or indigestion has also been reported with preventive use.
- Serious but uncommon reactions include hypersensitivity reactions such as difficulty breathing, throat tightness, rash or swelling of the face or throat, which can occur even days after a dose and require urgent medical attention.
- Nurtec ODT can also cause new or worsening high blood pressure, and can trigger new or worsening Raynaud's phenomenon, in which fingers or toes turn white or blue and feel cold or numb in response to cold or stress.
- Tell your healthcare provider promptly if you notice any of these signs, or if your migraines are not improving as expected.
Precautions & Warnings
- Nurtec ODT must not be used by anyone with a history of a hypersensitivity reaction to rimegepant or any component of the tablet, including a prior serious allergic reaction to the medicine.
- It should be avoided in people with severe liver impairment (Child-Pugh Class C), and used with caution in moderate liver impairment.
- Because Nurtec ODT can cause or worsen high blood pressure and Raynaud's phenomenon, tell your healthcare provider if you have a history of either condition.
- Safety in pregnancy and breastfeeding has not been fully established, so discuss the benefits and risks with your healthcare provider if either applies.
- For acute treatment, do not exceed one dose in 24 hours; safety of using more than 18 doses in a 30-day period has not been established, whether used for acute treatment, prevention, or a combination of both, so keep track of how often you use it and report frequent use to your healthcare provider.
Avoid Interactions
- Avoid taking Nurtec ODT with strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, clarithromycin and ritonavir, since these markedly raise rimegepant levels and increase the risk of side effects.
- With moderate CYP3A4 inhibitors or potent P-glycoprotein (P-gp) inhibitors, do not take another dose of Nurtec ODT within 48 hours.
- Avoid strong and moderate CYP3A4 inducers, such as rifampin, carbamazepine, phenytoin and St John's Wort, because they can reduce rimegepant levels and make it less effective.
- Tell your healthcare provider about all other migraine medicines you use, including other CGRP-targeted treatments or triptans, and about every prescription and over-the-counter medicine or supplement, so your regimen can be planned safely.
References
Frequently Asked Questions
Nurtec ODT (rimegepant) treats migraine in adults two ways: as an as-needed tablet for an attack already underway, or as a preventive tablet taken every other day to reduce how often migraines happen. The same 75 mg dose is used for both uses.
Place the Nurtec ODT tablet on or under your tongue and let it dissolve - no water needed. For acute migraine, take one dose as soon as symptoms start. For prevention, take one dose every other day, with or without food.
The most common side effect is nausea. Less often, Nurtec ODT can cause a serious allergic reaction with swelling or trouble breathing, sometimes days after a dose, or new or worsening high blood pressure or Raynaud's phenomenon (cold, white or blue fingers). Seek urgent care for allergic symptoms.
Avoid strong CYP3A4 inhibitors like ketoconazole or clarithromycin, which raise rimegepant levels. With moderate CYP3A4 or P-gp inhibitors, skip another dose for 48 hours. Avoid strong CYP3A4 inducers like rifampin or St John's Wort, which can make it less effective.
For acute treatment, take no more than one dose in 24 hours. Across acute and preventive use combined, safety beyond 18 doses in 30 days hasn't been established. Track your usage and tell your healthcare provider if you're using it very often.
Yes. Nurtec ODT is approved both to treat a migraine attack as it happens and, taken every other day, to prevent episodic migraines. Your healthcare provider will tell you which schedule fits your situation - the two uses aren't usually combined without guidance.
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