At a Glance
- Nurtec ODT is the brand name for rimegepant, a prescription medication used to manage migraine in adults.
- It can be used for acute treatment of migraine attacks, as well as for preventive treatment of episodic migraine.
- Rimegepant blocks the CGRP receptor and may reduce CGRP-related signaling involved in migraine.
- Clinical studies found that rimegepant performed better than placebo for some acute and preventive treatment outcomes, but not everyone became pain-free or responded in the same way.
- Side effects, possible drug interactions, liver or kidney health, pregnancy, breastfeeding, and other migraine treatments should be discussed with a healthcare professional.
Nurtec ODT is a prescription medication used in adults with migraine. Its active ingredient is rimegepant, a type of medication that acts on CGRP-related migraine pathways.
Some people are prescribed Nurtec ODT to treat migraine attacks when they happen. Others are prescribed Nurtec ODT on a regular schedule to help prevent episodic migraine. In some cases, it may be prescribed for both purposes.
Below, we explain what Nurtec ODT is, how it works, how it is taken, what the clinical studies found, and what safety points may be useful to discuss with a healthcare professional. This overview is for educational purposes and should not be taken as medical advice or as a comparison with other migraine approaches.
What Is Nurtec ODT?
Nurtec ODT is the brand name for rimegepant, a prescription medication used to manage migraine in adults. It is approved by the US Food and Drug Administration (FDA) for the acute treatment of migraine attacks with or without aura, as well as for the preventive treatment of episodic migraine.
The abbreviation ODT in the product name stands for orally disintegrating tablet. This means the tablet is designed to dissolve on or under the tongue, rather than being swallowed whole. Nurtec ODT contains 75 mg of rimegepant in each tablet.
Rimegepant belongs to a class of medications called calcitonin gene-related peptide receptor antagonists (Blair, 2023). These medications are also known as CGRP receptor antagonists or gepants. CGRP is a signaling molecule that plays a role in migraine biology, including pain-related pathways (Ho et al., 2010). Rimegepant works by blocking the CGRP receptor, which may reduce CGRP-related signaling involved in migraine.
Nurtec ODT is not a cure for migraine, and it does not work the same way for everyone. How it is used depends on whether it has been prescribed to treat migraine attacks, help prevent episodic migraine, or both.
What Is Nurtec Used For?
Nurtec ODT can be used in two different ways: as an acute treatment for a migraine attack after it has started, or as a preventive treatment to help reduce the number of migraine days over time.
For acute treatment, Nurtec ODT is used for migraine attacks with or without aura. Aura refers to temporary neurological symptoms that can happen before or during migraine, such as visual changes, tingling, or speech difficulty.
For preventive treatment of episodic migraine, Nurtec ODT is taken on a regular schedule, with the aim of reducing how often migraine attacks occur.
In simple terms, acute treatment is used for an attack that is already happening. Preventive treatment is used to help reduce future migraine days.
How Does Nurtec Work?
As mentioned previously, Nurtec ODT works by blocking the CGRP receptor. CGRP signaling occurs in the trigeminal system, a network involved in head and facial sensation. This system is closely linked with migraine-related pain signaling (Ho et al., 2010; Edvinsson et al., 2018).
During a migraine attack, CGRP can be released from trigeminal nerve pathways. This process may contribute to pain signaling, blood vessel changes, and neurogenic inflammation, where nerve activity helps drive inflammatory changes in sensitive tissues (Goadsby et al., 1993; Ho et al., 2010; Edvinsson et al., 2018).
Rimegepant is a CGRP receptor antagonist. It acts at the CGRP receptor, where it blocks CGRP from activating downstream signaling. Through reduced CGRP receptor signaling, rimegepant may help to interrupt part of the migraine process (Blair, 2023).
Although CGRP is an important part of migraine biology, it is not the only pathway involved. Migraine involves changes across brain networks, sensory processing, pain pathways, and vascular signaling. This is why blocking the CGRP receptor may help some people more than others, and why the response may vary from one migraine attack to the next (Goadsby, 2005; Ho et al., 2010).
How Is Nurtec Taken?
Nurtec ODT is taken as an orally disintegrating tablet. It is placed on or under the tongue and allowed to dissolve. Nurtec ODT can be taken with or without food. The tablet should be removed from the blister pack only when a person is ready to take it.
For acute treatment, Nurtec ODT is taken as needed when a migraine attack occurs. The recommended dose is one 75 mg tablet. The maximum dose in a 24-hour period is 75 mg, so more than one tablet should not be taken in the same day.
For preventive treatment of episodic migraine, Nurtec ODT is taken on a regular schedule. The recommended dose is one 75 mg tablet every other day.
The safety of using more than 18 doses in a 30-day period has not been established. This is especially relevant for people using Nurtec ODT for both acute and preventive treatment, since total monthly use may need to be tracked carefully. Anyone prescribed Nurtec ODT should follow the dosing instructions given by their healthcare professional, including guidance about other medications, medical conditions, and what to do if a dose is missed.
What Did Clinical Studies Find?
Clinical studies tested rimegepant against placebo for both acute migraine treatment and preventive treatment of episodic migraine. These studies looked at group results, which means they show average differences between people taking rimegepant and people taking placebo. They do not guarantee how an individual person will respond.
In an acute treatment study, adults with a history of migraine and two to eight moderate or severe migraine attacks per month were given either a single 75 mg dose of rimegepant or placebo to treat one migraine attack (Lipton et al., 2019). Researchers measured outcomes two hours after dosing. Pain freedom at two hours occurred in 19.6% of people taking rimegepant, compared with 12.0% of people taking placebo. Freedom from the most bothersome symptom at two hours occurred in 37.6% of people taking rimegepant, compared with 25.2% of people taking placebo.
A further acute treatment study, summarized in the prescribing information, measured pain relief at two hours. In this study, pain relief was defined as improvement from moderate or severe headache pain to mild or no pain. This occurred in 59.3% of people taking rimegepant, compared with 43.3% of people taking placebo. The prescribing information also reported sustained pain freedom from two to 48 hours in 13.5% of people taking rimegepant, compared with 5.4% of people taking placebo.
In a preventive study, adults with at least a one-year history of migraine were assigned to take rimegepant 75 mg or placebo every other day for 12 weeks (Croop et al., 2021). During weeks 9 to 12, people taking rimegepant had an average reduction of 4.3 monthly migraine days, compared with 3.5 fewer monthly migraine days in the placebo group.
Overall, these results suggest that rimegepant performed better than placebo in both acute and preventive studies, although the size of the benefit varied by outcome. As with many migraine studies, some people in the placebo groups also improved. Because these were group averages, the results do not predict exactly how any one person will respond.
What Are the Possible Side Effects and Safety Considerations?
As with other prescription medications, Nurtec ODT can cause side effects.
The most common side effect when used for acute treatment is nausea. For preventive treatment of episodic migraine, the most common side effects include nausea, stomach pain, and indigestion.
Serious side effects can also occur. These may include allergic reactions, which can sometimes happen days after taking Nurtec ODT. Symptoms may include rash, trouble breathing, or swelling of the face, mouth, tongue, or throat. High blood pressure or worsening high blood pressure has also been reported. Reports have also included Raynaud’s phenomenon, a circulation problem that can affect the fingers or toes.
Nurtec ODT may not be appropriate for everyone. People should tell their healthcare professional about other medications or supplements they take and any liver or kidney problems. They should also discuss pregnancy, plans to become pregnant, or breastfeeding. Anyone prescribed Nurtec ODT should follow their healthcare professional’s instructions and review the patient information or prescribing information for a full list of possible side effects, warnings, and interactions.
Questions to Ask a Healthcare Professional
Useful questions may include:
- Is Nurtec ODT being used to treat migraine attacks, help prevent episodic migraine, or both?
- What should I know about dose, timing, and whether to take Nurtec ODT with food?
- Could Nurtec ODT interact with current medications or supplements?
- What side effects or warning signs should I look for?
- How long should I track migraine symptoms before reviewing whether Nurtec ODT is helping?
These questions can help guide a more informed discussion about whether Nurtec ODT is appropriate for an individual situation.
This content is for informational and educational purposes only and is not intended as medical advice. Always consult a healthcare professional before making health-related decisions.
