Dr. Ahmed Nurtec is not FDA-approved for the treatment of migraine headaches in children
Migraine is not exclusive to adults, as nearly 2.5% of children under 7 years of age have experienced at least one episode. It affects children of both genders before puberty and in early childhood, and its progression and occurrence are different from those of adults.
Even though kids have a shorter migraine duration, it can prevent them from going to school or performing daily activities. Additionally, preventive treatments for the pediatric population often come with undesirable side effects.
Moreover, unlike adults, children get migraines that affect both sides of the head and not just one. However, CGRP antagonists like Nurtec ODT are approved only for use in adults.
Symptoms of Migraine in Children
The most common migraine symptom in children is a pounding headache, which can affect both sides or any part of the head.
Some other common migraine symptoms in children include:
- Dizziness
- Lightheadedness
- Light and sound sensitivity
- Loss of appetite
- Nausea
- Inability to focus
Chronic Migraine in Children
Chronic migraine in children is characterized by migraine attacks that happen for 15 or more days per month or at least for 3 months. Sadly, as compared to adults, migraines are difficult to diagnose in children as they do not know how to describe the symptoms correctly.
Children who have migraine attacks are often unresponsive to first-line treatments like OTC medicines, tricyclic antidepressants, etc. These drugs do not come without typical side effects like drowsiness, cognitive abnormalities, and weight gain.
Role of Nurtec in Pediatric Migraine Treatment
Nurtec ODT is a CGRP (Calcitonin gene-related peptide) antagonist that works by inhibiting CGRP, a neuropeptide that plays a significant role in migraine development. By blocking CGRP, Nurtec ODT offers relief against classic migraine symptoms.
Currently, most of the scientific data regarding Nurtec’s efficacy is based on the treatment of migraines in adults. However, these researches also target migraine prevention, making it a good choice for migraine treatment in children.
There is a greater need to have effective medications for migraine treatment in children. Therefore, the American Headache Society and special interest groups recommend the use of anti-CRGP therapies in children and adolescents but with proper attention to factors like age, pubertal state, and other comorbidities. [Ref]
Another benefit of rimegepant is its double action on pain relief and migraine prevention. According to studies, Nurtec reduces up to 50% of migraine reoccurrence in a month, but still, more data is needed to confirm its safety among children. [Ref]
One study published in the journal Headache found that CGRP antagonists were effective in migraine treatment for adolescents aged 12-21. This study also concludes that rimegepant and ubrogepant are associated with fewer headache days in patients with chronic migraines. [Ref]
Is Nurtec ODT safe for use in children?
Safety is the first consideration when prescribing medicines to children because they might have completely different reactions to a drug than adults.
Fortunately, Nurtec ODT has a very satisfying safety profile so far. Moreover, it is not an injectable drug, so you don’t have to worry about injection site reactions either.
Clinical trials done on adults suggest that rimegepant is well tolerated with no serious side effects. Mild side effects include nausea and tiredness, which are generally resolved on their own. [Ref]
Moreover, Nurtec ODT also addresses the problem of “rebound” headaches associated with medication overuse. This is a critical concern when using migraine medication in children and is also related to the use of painkillers.
Nurtec ODT targets the root cause of migraine headaches, and that is why it also breaks the cycle of reoccurring headaches.
Other Concerns
Although Nurtec ODT seems to be a promising approach for chronic migraine treatment in children, it is yet not officially recommended due to the following issues:
- More data is needed to check its long-term safety in the pediatric population.
- Even if Nurtec ODT is considered safe for use, there is no recommended dosage for patients less than 18 years of age. That is why, without a set dosage, it cannot be prescribed for children yet.
- Nurtec ODT is an expensive medicine, and getting insurance coverage is difficult for some people. Additionally, not all insurance plans offer full coverage for this drug.
Conclusion
Chronic migraine in children can be very disturbing as they highly hinder their daily activities, school performance, and cognitive abilities. Unfortunately, patients in this age group are unable to correctly define their symptoms, which makes treatment even more complex.
Most of the traditional medicines come with too many side effects that can’t be risked in children or adolescents. Nurtec ODT is a newer, safer treatment option that is effective in reducing migraine frequency and severity. It is an effective and safe option for migraine prevention in adults. However, more research is needed to investigate the safety of Nurtec ODT in children.
