Drug Detail:Ubrogepant (Ubrogepant)
Drug Class: CGRP inhibitors
Usual Adult Dose for Migraine
Initial dose: 50 to 100 mg orally, once
- After 2 hours, a second dose may be taken if needed
Comments:
- The safety of treating more than 8 migraines in a 30-day period is unknown.
Use: For the acute treatment of migraine with or without aura.
Renal Dose Adjustments
Mild or moderate renal impairment: No adjustment recommended
Severe renal impairment (CrCl 15 to 29 mL/min): Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed; Maximum dose: 100 mg in 24-hours
ESRD (CrCl less than 15 mL/min): Avoid use
Liver Dose Adjustments
Mild or Moderate Hepatic Impairment (Child-Pugh A or B): No adjustment recommended
Severe Hepatic Impairment (Child-Pugh C): Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed; Maximum dose: 100 mg in 24-hours
Dose Adjustments
Elderly: Dose selection should be cautious, consider starting at the low end of the dosing range
Concomitant Use with CYP450 3A4 Inhibitors:
- With Strong CYP450 3A4 Inhibitors: Contraindicated
- With Moderate CYP450 3A4 Inhibitors: 50 mg orally once in 24 hours
- With Weak CYP450 3A4 Inhibitors: Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed; Maximum dose: 100 mg in 24-hours
Concomitant Use with CYP450 3A4 Inducers:
- With Strong CYP450 3A4 Inducers: Avoid concomitant use
- With Weak and Moderate CYP450 3A4 Inducers: Initial dose: 100 mg orally once; a second dose of 100 mg may be taken 2 hours after initial dose
Concomitant Use with BCRP and/or P-gp Only Inhibitors: Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed
Precautions
CONTRAINDICATIONS:
- Concomitant use of strong CYP450 3A4 inhibitors
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Take orally with or without food
General:
- This drug is the first oral calcitonin gene-related peptide receptor antagonists approved for the acute treatment of migraine.
Patient advice:
- Patients should be instructed to read the US FDA-approved patient labeling (Patient Information).
- Patients should understand that this drug interacts with a number of other drugs and it is important to report all other medications being used, including over the counter and herbal products; dose modifications may be necessary.
- Patients should be instructed to avoid grapefruit juice during therapy.
- Patients who are pregnant or planning to become pregnant should discuss this with their healthcare provider.
- Patients who are breastfeeding or planning to breastfeed should discuss this with their healthcare provider.
Frequently asked questions
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