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Medicines > uses : ADHD in children (6+), adolescents, and adults (FDA-approved 2021 for pediatric, 2022 for adult) or Acute treatment of migraine with or without aura in adults or Preventive treatment of migraine in adults (episodic and chronic)

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generic:
None (4)
brand:
Aimovig (1) · Ajovy (1) · Qelbree (1) · Zavzpret (zavegepant) (1)
classes:
Anti-CGRP ligand monoclonal antibody (1) · Anti-CGRP receptor monoclonal antibody (1) · CGRP receptor antagonist (1) · Gepant (1) · non-stimulant ADHD agent (1) · Selective norepinephrine reuptake inhibitor (NRI) with 5HT1A partial agonism (1)
mechanism:
Humanized IgG2 monoclonal antibody binding both isoforms of CGRP peptide (1) · Humanized IgG2 monoclonal antibody binding the CGRP receptor (not the peptide); blocks CGRP-mediated vasodilation and nociceptive signaling (1) · Selective NET inhibitor (no significant DAT activity, distinguishes from amphetamine/methylphenidate). Also: 5HT1A receptor partial agonism, 5HT2B and 5HT7 receptor antagonism. The serotonergic actions may underlie better tolerability and possibly different efficacy spectrum than atomoxetine. (1) · Small-molecule CGRP receptor antagonist; intranasal formulation (1)
uses: (Click arrow to add another value)
starting dose:
10 mg (one spray) intranasally in one nostril (1) · 225 mg SC monthly, or 675 mg SC every 3 months (quarterly) (1) · 70 mg SC monthly; may increase to 140 mg monthly (1) · Pediatric 6-11: 100 mg PO daily, titrate weekly to max 400 mg. Adolescent 12-17: 200 mg, max 400 mg. Adult: 200 mg, max 600 mg. (1)
preparations:
10 mg/spray nasal solution (1) · 100 mg, 150 mg, 200 mg extended-release capsules (can be sprinkled on food) (1) · 225 mg/1.5 mL prefilled syringe or autoinjector (1) · 70 mg/mL or 140 mg/mL prefilled autoinjector (1)
fda max:
10 mg per 24 h (1) · 140 mg/month (1) · 400 mg/d (pediatric); 600 mg/d (adult) (1) · 675 mg/quarter (1)
routes:
Intranasal (1) · Oral (1) · Subcutaneous (2)
onset:
ADHD symptom improvement reported within 1-2 weeks (faster than atomoxetine which takes 4-6 weeks) (1) · Onset of preventive effect over weeks; some patients respond after first dose (1) · Over weeks (1) · Pain relief reported within 15 min in trials (1)
duration:
Daily dosing (1) · Monthly dosing (1) · Monthly or quarterly dosing (1) · ~48 h sustained pain freedom in responders (1)
halflife:
~28 days (1) · ~31 days (1) · ~6.6 h (1) · ~7 hours (1)
bioavailability:
Adequate oral bioavailability with extended-release formulation (1) · Not formally established (1) · ~5% intranasal (1) · ~82% SC (1)
pregnancy:
Limited data (1) · Limited data; avoid (3)
legal:
Rx (3) · Rx, '''not a controlled substance''' (no DEA scheduling) (1)

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