Usual Adult Dose for Migraine Prophylaxis

10 mg, 30 mg, or 60 mg orally once a day

Use: For the preventative treatment of episodic migraine.

Renal Dose Adjustments

Mild to Moderate Renal Impairment : No adjustment recommended
Severe Renal Impairment and ESRD (CrCl less than 30 mL/min): 10 mg orally once a day

Liver Dose Adjustments

Mild to moderate hepatic impairment : No adjustment recommended
Severe hepatic impairment : Avoid use

Dose Adjustments

Elderly: Dose selection should be cautious, generally starting at the low end of the dosing range

Concomitant CYP450 3A4 Inducers/Inhibitors:

• Strong CYP450 3A4 inhibitor: 10 mg orally once a day
• Strong and moderate CYP450 3A4 inducers: 30 mg or 60 mg orally once a day
• OATP inhibitors: 10 mg or 30 mg orally once a day

Precautions

CONTRAINDICATIONS: None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

For patients undergoing intermittent dialysis: 10 mg orally once a day with dose to be administered after dialysis

Other Comments

Administration advice:

• Take orally once a day with or without food

• This drug is a second-generation oral calcitonin gene-related peptide (CGRP) receptor antagonist developed specifically for the treatment of migraine; it was developed with the goal of minimizing the risk of drug-induced liver injury observed with other members of this drug class.

• Patients should be instructed to read the US FDA-approved patient labeling (Patient Information).
• Patients should understand that this drug may interact with other drugs and dose adjustments may be necessary; patients should be instructed to report use of all prescription medications, over-the-counter medications, herbal products, and/or grapefruit to their healthcare provider.

Frequently asked questions

• What are the new drugs for the treatment of migraines?
• How do Ubrelvy, Qulipta and Nurtec compare for migraines?