Rimegepant: Difference between revisions

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{{MedTemplate

| generic = Rimegepant

| brand = Nurtec

| brand = Nurtec ODT

| classes = Gepant, Migraine medicine

| structure =

| mechanism = CGRP receptor ~~antagonist~~

| classes = [[:Category:Gepants|Gepant (small-molecule CGRP receptor antagonist)]], [[:Category:Antimigraine medicines|Antimigraine medicine]], [[:Category:Analgesics|Analgesic]]

| uses = <vote slug="acute-migraine-use">Acute migraine with or without aura (FDA, 2020)</vote>, <vote slug="migraine-prophylaxis-use">Migraine preventive treatment (FDA, 2021; '''the first medicine with both acute and preventive migraine indications''')</vote>

| starting_dose = Acute migraine: 75 mg PO at onset, maximum one dose per 24 hours. Preventive: 75 mg PO every other day

| preparations = Orally disintegrating tablet 75 mg

| fda_max = 75 mg per dose; one dose per 24 hours (acute); one dose every other day (preventive)

| pill_id =

| routes = Oral (sublingual disintegration)

| onset = 1-2 hours for migraine relief

| duration = ~48 hours of headache freedom

| halflife = ~11 hours<ref name="nurtec-label">FDA Prescribing Information, Nurtec ODT (rimegepant), Biohaven/Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/212728s003lbl.pdf</ref>

| bioavailability = ~64% (oral)<ref name="nurtec-label" />

| pregnancy = Limited human data.{{citation needed}}

| legal = [[USLegal:Prescription only|Rx-only]] in US

| mechanism = <vote slug="rimegepant-mech-claim">Small-molecule antagonist of the calcitonin gene-related peptide (CGRP) receptor, the first oral CGRP-targeting agent in widespread clinical use. CGRP is the dominant pro-migraine neuropeptide released from trigeminal nerve terminals; blocking its receptor blunts the neurogenic inflammation that drives migraine pain.</vote> '''Unlike triptans, rimegepant does not cause vasoconstriction''' and is safe in patients with coronary artery disease and other vascular conditions where triptans are contraindicated. The dual acute-and-preventive indication is the unique pharmacological feature among migraine medicines. The second-generation gepants (rimegepant, ubrogepant, atogepant) have a clean hepatic-safety profile compared to the first-generation gepants withdrawn during development for hepatotoxicity<ref name="nurtec-label" />.

}}

== References ==

[[Category:Gepants]]

[[Category:Antimigraine medicines]]

[[Category:Analgesics]]

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