What is Rimegepant: Uses, Dosage, Side Effects and More

Rimegepant is a prescription medication specifically designed to treat and prevent migraine headaches. This oral medication belongs to a newer class of drugs called CGRP receptor antagonists, which work by blocking specific pain signals in your brain that trigger migraines.

If you're dealing with frequent migraines, you're likely searching for relief that actually works. Rimegepant offers hope for many people who haven't found success with other treatments, providing both immediate relief during an attack and preventive protection when taken regularly.

What is Rimegepant?

Rimegepant is a targeted migraine medication that blocks CGRP receptors in your brain. CGRP stands for calcitonin gene-related peptide, which is a protein that plays a key role in triggering migraine pain and inflammation.

This medication comes as an orally disintegrating tablet that dissolves on your tongue within seconds. You don't need water to take it, making it convenient during a migraine attack when you might feel nauseous or have trouble swallowing.

Rimegepant is considered a moderate-strength migraine medication. It's not as strong as some injectable treatments, but it's more targeted than over-the-counter pain relievers, offering a middle ground for effective migraine management.

What is Rimegepant Used For?

Rimegepant serves two main purposes for migraine sufferers. It can stop a migraine attack that's already started, and it can prevent future migraines when taken regularly.

For treating active migraines, rimegepant works best when taken as soon as you notice the first signs of an attack. Many people find it effective for the throbbing head pain, nausea, and sensitivity to light and sound that come with migraines.

As a preventive treatment, rimegepant can reduce how often you get migraines and make them less severe when they do occur. Your doctor might recommend this approach if you have frequent migraines that significantly impact your daily life.

How Does Rimegepant Work?

Rimegepant works by blocking CGRP receptors in your brain and blood vessels around your head. When these receptors are activated during a migraine, they cause blood vessels to dilate and release inflammatory substances that create the intense pain you feel.

Think of CGRP as a key that unlocks the door to migraine pain. Rimegepant acts like a shield, preventing that key from fitting into the lock and stopping the pain cascade before it fully develops.

This targeted approach means rimegepant specifically addresses migraine mechanisms rather than just masking pain. The medication typically starts working within 2 hours, with many people experiencing relief even sooner.

How Should I Take Rimegepant?

Taking rimegepant is straightforward, but following the proper method ensures you get the full benefit. Place the tablet on your tongue and let it dissolve completely, which usually takes about 30 seconds.

You can take rimegepant with or without food, and you don't need water since the tablet dissolves on its own. However, if you're using it to treat an active migraine, avoid taking it on a completely empty stomach as this might worsen nausea.

For treating a migraine attack, take one 75mg tablet as soon as you notice symptoms starting. Don't wait for the pain to become severe. For prevention, your doctor will typically prescribe one tablet every other day, but follow their specific instructions.

Handle the tablet gently and don't remove it from the blister pack until you're ready to take it. The medication can be damaged by moisture, so keep your hands dry when handling it.

How Long Should I Take Rimegepant For?

The duration of rimegepant treatment depends on whether you're using it to treat individual migraines or prevent them. For treating single migraine attacks, you only take it when needed, with no ongoing schedule.

If you're using rimegepant for prevention, your doctor will typically recommend trying it for at least 3 months to see if it reduces your migraine frequency. Some people need longer to experience the full preventive benefits.

Your doctor will regularly check how well the medication is working for you. They'll consider factors like how often you're getting migraines, how severe they are, and whether you're experiencing any side effects that outweigh the benefits.

What Are the Side Effects of Rimegepant?

Most people tolerate rimegepant well, but like all medications, it can cause side effects. The good news is that serious side effects are uncommon, and many people experience no side effects at all.

Here are the most common side effects you might experience:

• Nausea or stomach discomfort
• Sleepiness or fatigue
• Decreased appetite
• Abdominal pain or indigestion
• Diarrhea
• Dizziness
• Dry mouth

These common side effects are usually mild and tend to improve as your body adjusts to the medication. Most people find they can manage these effects without needing to stop treatment.

Less common but more serious side effects require immediate medical attention. While rare, some people may experience allergic reactions, severe liver problems, or unusual changes in mood or behavior.

Signs of a serious allergic reaction include difficulty breathing, swelling of your face, lips, tongue, or throat, and widespread rash or hives. If you experience any of these symptoms, seek emergency medical care immediately.

Who Should Not Take Rimegepant?

Rimegepant isn't suitable for everyone, and certain health conditions or medications can make it unsafe. Your doctor will carefully review your medical history before prescribing this medication.

You should not take rimegepant if you have severe liver disease or kidney problems. The medication is processed through these organs, and impaired function can lead to dangerous buildup in your system.

People taking certain medications that strongly affect liver enzymes should avoid rimegepant. This includes some seizure medications, certain antibiotics, and specific antifungal drugs that can interfere with how your body processes the medication.

If you're pregnant or breastfeeding, discuss the risks and benefits with your doctor. While there's limited data on rimegepant's safety during pregnancy, your doctor can help you weigh the potential benefits against any possible risks.

Children under 18 years old shouldn't take rimegepant, as its safety and effectiveness haven't been established in this age group.

Rimegepant Brand Names

Rimegepant is sold under the brand name Nurtec ODT in the United States. ODT stands for "orally disintegrating tablet," which describes how the medication dissolves on your tongue.

This is currently the only brand name available for rimegepant, as it's a newer medication still under patent protection. Generic versions aren't yet available, which means the medication can be more expensive than older migraine treatments.

When talking to your doctor or pharmacist, you can refer to the medication by either name - rimegepant or Nurtec ODT - and they'll know exactly what you mean.

Rimegepant Alternatives

If rimegepant isn't right for you, several other migraine treatments might work better. The choice depends on your specific symptoms, medical history, and how well you've responded to other medications.

Other CGRP medications include ubrogepant (Ubrelvy) for treating active migraines, and erenumab (Aimovig) or fremanezumab (Ajovy) for prevention. These work similarly to rimegepant but have different dosing schedules and side effect profiles.

Traditional migraine medications like triptans (sumatriptan, rizatriptan) remain effective options for many people. These work differently than rimegepant but can be equally effective, especially if you've used them successfully before.

For prevention, doctors might recommend daily medications like topiramate, propranolol, or amitriptyline. These older medications have more research behind them and might be better choices if you have other health conditions they can help with.

Is Rimegepant Better Than Sumatriptan?

Rimegepant and sumatriptan work through different mechanisms, making them each better suited for different people. Neither is universally superior, and the best choice depends on your individual situation and response to treatment.

Sumatriptan has been available longer and has more extensive research supporting its effectiveness. It often works faster for severe migraines and is available in multiple forms including injections, nasal sprays, and tablets.

Rimegepant offers advantages for people who can't take triptans due to heart conditions, high blood pressure, or stroke risk. It's also less likely to cause medication overuse headaches if taken frequently.

Some people find rimegepant causes fewer side effects than sumatriptan, particularly avoiding the chest tightness, drowsiness, or "triptan sensations" that some experience with sumatriptan.

The choice between these medications often comes down to your medical history, how quickly you need relief, and which side effects you're more willing to tolerate.