Drilldown: Medicines

None (5)

Aimovig (1) · Belsomra (1) · Dayvigo (1) · Emgality (1) · Quviviq (1)

Anti-CGRP ligand monoclonal antibody (1) · Anti-CGRP receptor monoclonal antibody (1) · Dual orexin receptor antagonist (DORA) (3) · the first approved (1)

None (1) · Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance. (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Humanized IgG2 monoclonal antibody binding the CGRP receptor (not the peptide); blocks CGRP-mediated vasodilation and nociceptive signaling (1) · Humanized IgG4 monoclonal antibody binding CGRP peptide; prevents CGRP from activating its receptor (1)

Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1) · Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1) · Preventive treatment of migraine in adults (episodic and chronic) (1) · Preventive treatment of migraine in adults; episodic cluster headache (1)

10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1) · 5 mg PO at bedtime; may increase to 10 mg if inadequate (1) · 70 mg SC monthly; may increase to 140 mg monthly (1) · Migraine: 240 mg SC loading dose, then 120 mg SC monthly. Cluster: 300 mg SC at onset of cluster period, then monthly during cluster. (1)

120 mg/mL prefilled syringe or autoinjector (1) · 25 mg, 50 mg tablets (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 70 mg/mL or 140 mg/mL prefilled autoinjector (1)

10 mg/d (1) · 140 mg/month (1) · 20 mg/d (1) · 240 mg loading + 120 mg/month for migraine; 300 mg/month for cluster (1) · 50 mg/d (1)

Oral (3) · Subcutaneous (2)

Onset of preventive effect over weeks; some patients respond after first dose (1) · Over weeks (1) · ~30 min (3)

None · 24 hours · 4-6 hours · 12 hours · 6-8 hours · Daily dosing · 8-12 hours · 12-24 hours · Hours · Hours per application · 24 hours (HS dosing) · 24 hours (once-daily dosing) · 24 h · N/A · N/A (replacement) · Variable · ~7-8 hours · 3-5 hours · 4-6 hours (IR); 24 hours (ER) · 6-12 hours

Other values:

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~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~27 days (1) · ~28 days (1) · ~8 hours (shorter than suvorexant and lemborexant) (1)

Not formally established (high SC) (1) · ~44% (1) · ~62% (1) · ~82% (1) · ~82% SC (1)

Limited data; avoid (5)

Rx (2) · Rx, Schedule IV (US) (3)