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Nurtec and Medication Overuse Headaches

Nurtec and MOH

Migraines can be a burden as they hinder daily activities. However, what’s more irritating is trying to fix a migraine with meds and ending up with medication overuse headaches.

According to recent data, migraines affect almost 15% of the global population. [Ref]. This makes all the migraine sufferers more prone to medication overuse headaches.

Popular migraine medications like analgesics, triptans, and opioids have a relatively greater chance of causing medication overuse headaches.

However, Nurtec ODT, a newer medication, is reported to be free of the additional risk of medication overuse headaches.

What are Medication Overuse Headaches (MOH)?

Migraine patients often notice that taking migraine medications to prevent its symptoms usually causes additional headaches due to drug overuse.

That is why the term “Medication Overuse Headaches”, explains when the pain relievers overuse leads to additional headaches. MOH usually happens when migraine occurs for at least 15 days a month.

This is concerning for migraine patients as they have to choose when they can use the “as needed” meds and when they have to leave the pain untreated to avoid overuse complications.

Nurtec ODT can be taken as a preventive and “as needed” medicine without the constant threat of medication overuse headaches.

How does Nurtec ODT prevent Medication Overuse Headaches?

Nurtec ODT is a CGRP receptor antagonist that has been named a “game changer” in the treatment of chronic migraines.

It was approved by the FDA in 2020, and one of its unique properties is its dual action in acute treatment and preventive therapy of migraines.

Nurtec ODT is a promising solution to medication overuse headaches because of the following properties:

  • Nurtec ODT has a long half-life, so its action lasts up to 48 hours. This means a single dose of the drug can prevent migraines for a longer duration, ultimately decreasing the need for repeated dosage.
  • Nurtec’s preventive action decreases acute migraine symptoms, which further decreases migraine incidence and eliminates the need to take medication frequently.
  • It has a non-addictive profile because of its direct target on the CGRP pathway. Unlike opioids, Nurtec ODT has a low risk of dependency.
  • Moreover, it is well-tolerated with fewer side effects, making it a good preventive therapy for migraines.

Nurtec ODT and MOH – Scientific Insights

The role of Nurtec ODT in reducing medication overuse headaches is backed by various studies.

According to a real-world administrative study published in “Neurology,” it was found that among 119.396 migraine patients, the frequency of MOH period prevalence reduced from 0.44 to 0.13% in three months.

Meanwhile, in 81,683 patients, the same frequency decreased to 0.57-0.21% over a 6-month period. For a 9-month period, the frequency in 60,960 people lowered to 0.75%. This suggests that Nurtec readily reduces the burden of MOH. [Ref]

Another study assessed the use of opioids in patients after initiation of treatment with Nurtec. The study found a 16.06% decrease in total opioid fills and a 2.84% decrease in monthly MME (morphine milligram equivalents) dispensed.

This clearly shows a significant decrease in opioid use after initiation of rimegepant therapy. [Ref]

One study evaluating the efficacy of rimegepant in migraine treatment suggested that this medication is a modest therapeutic gain as it does not cause medication overuse headaches.

Moreover, it does not induce vasoconstriction, making it suitable for cardiac patients with migraines. [Ref]

However, currently, there is limited scientific data available on Nurtec’s role in reducing medication overuse headaches. However, a number of studies have proven that Nurtec readily reduces episodic migraines. 

A recent study suggests that rimegepant reduces the severity and frequency of migraine attacks, improving daily functioning.

Moreover, the study claimed that 59.3 % of patients following rimegepant therapy experienced pain relief within two hours of dosing.

Additionally, the study reported that it was an effective and safe option for long-term migraine treatment. [Ref]

The long-term safety of Nurtec, proven by scientific evidence, indicates that it has a low risk of medication overuse headaches.

Migraine Medications and Risk of MOH

A list of commonly used migraine medications with the severity of medication overuse headaches associated with each of them.

Important Considerations Before using Nurtec ODT

While Nurtec has been proven to be a very beneficial addition to migraine treatment, there are some things you need to consider beforehand.

  • Nurtec is a relatively expensive drug, and insurance coverage might vary. So, you must carefully evaluate the affordability before selecting the treatment plan.
  • Nurtec might not be the solution for every patient, and some patients might still require alternative medicines.
  • Although Nurtec has a low risk of MOH, it should still be used as directed because there can be other side effects.

Conclusion

Medication overuse headaches can be frustrating when you already experience migraine. And sometimes, it can be complex to treat.

Nurtec ODT is a good solution to avoid MOH as its dual action reduces the symptoms and prevents recurrence.

However, effective management comes when you work along with your doctor to combat the condition and the side effects.

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

Here is a link to My Facebook Page. You can also contact me by email at contact@dibesity.com or at My Twitter Account
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