Nurtec (Rimegepant) has been recently approved for the prevention of episodic migraine. Until recently, all the CGRPR (calcitonin gene-related peptide receptor) inhibitors, that got FDA approval for migraine prevention were available as injectable medicines.
Nurtec is a CGRPR inhibitor that is available for oral use as ODT (oral disintegrating tablets). It was initially approved for the abortive treatment of acute attacks of episodic and chronic migraine headaches.
Now, as it has been approved for the prevention of episodic migraine, it can be taken in a dose of 75 mg every other day [Ref]. The maximum dose per month has been increased from 15 to 18 doses per month.
Drugs from the same class that are used for migraine prevention include:
Nurtec for Migraine Prevention: Efficacy in Clinical Trials:
People think clinical trials are usually biased. They may be right. However, evaluating the efficacy of a drug in real life is also difficult since people don’t use any scales to measure “before and after effects”.
These reviews are therefore not helpful all the time. In addition, people may associate an unpleasant experience with a drug that in reality is not due to the drug.
Before discussing the patient’s reviews and experiences, let’s first look at the efficacy of Nurtec for migraine prevention in clinical trials.
In the clinical trial, it reduced the number of migraine days by a mean of 4.3 days compared to 3.5 days in the placebo group (P = 0.010).
Similarly, 49.1% of the patients noticed a reduction in their migraine severity by 50% or more compared to 41.5% in the placebo group (P = 0.044).
Although, clinically significant (as suggested by the p values), it can not be considered a magical drug as some people think.
We collected data from patients who have been using or have used Nurtec for migraine prevention.
Their actual comments are presented here:
Nurtec for Migraine Prevention: People who found it AWESOME!
Many people who wrote their Nurtec Review on Reddit were using it for migraine prevention.
“I am new here and have been struggling with my mental health (anxiety and depression). I’ve been on antidepressants, stimulants, etc.
Around 12 different types of medications over the past 2 years and only felt worse with so many side effects.
I even ended up in the mental hospital at one point. I tried Nurtec for the first time and used it every other day for about a week.
This is the clearest I have felt in years. I still struggle mentally but nowhere as bad. My energy level is up, my mood is up, and my social life is getting better.
“I’ve been taking it for several months. I feel things are getting better the longer I’m on it. Definitely a game-changer.”
“I’ve been on it as a preventative for over a month now, it has literally been a lifesaver for me. It took a few days of use to get going but I have not had a migraine in over a month, coming from having them 3 days a week.
On rare occasions, I can feel the migraine around the eyes trying to push thru but it stops at that point and I’m left with a “feeling” around the eyes but not a headache/migraine.”
“I’ve been on it since June for prevention. The biggest thing for me is that it restored my cognitive function. I still have a few days here and there where I struggle a bit, but not every day like before and nowhere near as intensely.”
“I have been on it as a preventative for 1.5 months. It’s literally changed my life so much. So grateful for it!”
“Okay so Nurtec doesn’t really work as an abortive for me but it’s working so well as preventative which is crazy and unexpected.
I asked for it as a last result because I’ve failed all the injectables and Botox so I really didn’t think it would work. I get it for free with the coupon”
“I take Nurtec every other day for prevention. It’s working great!”
“Getting prescribed Nurtec changed my life. After trying SO many preventative and abortive medicines, my neurologist prescribed Nurtec.”
“For about the first month, I wasn’t sure if it was going to work, but after that, it is the only medication that has been able to impact my migraines.”
“Works great for me. I may switch from Aimovig to Nurtec every 48 hours as a preventative CM treatment. It just cuts down the breakthrough migraines.”
“I have always had a headache/migraine every day, and this is the only medicine that has reduced the frequency and intensity of my headaches.”
“I was prescribed to take it every other day so it functions as both preventative and abortive medication. I’ve had no side effects and am so thankful for this medicine! It was a decades-long process to get here but I’m happy to have finally found something that works!”
“I was getting it as a preventative and thought it was amazing. My doctor just took me off it to try Vyepti, but I still use what I have as an abortive. I love it.”
“I’m on it for prevention, and along with continuous birth control I’m down to 0-3 attacks a month and most respond to OTCs!”
“Nurtec works for me but takes 5+ hours. Ubrelvy kinda sorta works after 6 hours then wears off almost immediately.
Nurtec keeps working for about 24 hours after it starts working. Now I’m taking Nurtec preventively every other day so it doesn’t matter as much how long it takes to work.”
“Took me a couple of doses for it to work when I first started taking it. Now I have it as a preventative and abortive and it’s been very effective.”
“I take Nurtec every other day preventively. It’s amazing.
I started in August and the last time I needed a rescue med was Sept. 4. I was having headache pain almost every day before that.”
“I have been taking it as a preventative since middle July and only 2 migraines so far and one was optical with no pain!! I’m super excited about it!!”
“I take it every other day and it’s been a lifesaver for me”.
“I take Nurtec every other day as a preventative!! It’s been amazing. I have had one migraine in a month. That’s a record for me”
“I’ve been on Nurtec as an abortive for over 6 months. Just started taking it as a preventative at the beginning of September and I’m now on my 21st day in a row without a migraine.
Pretty awesome because a year ago I was averaging 12-15 per month.”
“I would say the only bad part is insurance doesn’t want to pay anything for it.
I’m using the Nurtec one source program but have to keep trying to get insurance to pay which means calling my doctor’s office for prior authorization submissions”.
Before being prescribed Nurtec, it is important to check up on your insurance. Without insurance, it is difficult to use Nurtec on a long-term basis, especially for the prevention of migraine headaches.
“I’ve been on it every other day for ~6 weeks. It has given me a lot of cognitive function back, so I’m very happy with it.
No effect on vestibular symptoms, but those may not have to do with CGRP or migraine”.
“I was not able to keep up with hormone-triggered attacks (which account for most of my days with pain), so I started hormonal BC, and have had 12 headache days this month vs 20+ for most months this year, so hormones were a bigger player as far as headache days for me”
“It’s entirely possible that CGRP is not implicated in your migraine process, or is a minor factor.
If you haven’t already tried Emgality/ Ajovy/ Vyepti, they work differently from Nurtec and Aimovig, so one of them may be worth trying if Nurtec isn’t working after a couple of months”
“I’m using it as a preventative. I have been migraine free for 11 days which is a miracle. I take it every other day. Fingers crossed!”
“I have been on it for a week now as a preventative. I have had a few low-level headaches but they don’t get to a full-blown migraine. So far so good! No side effects”
“It’s my prevention along with continuous birth control and was my abortive before that.
As an acute treatment it worked for me within 20 min and I felt great the next day. The combo I’m on now has me down to 1-3 attack days a month and maybe 10 days with mild vestibular symptoms”.
“I take it as an abortive med and I take Botox for prevention. I love both of them.”
“Nurtec has given me some sanity. I take it every other day as preventive medicine and Triptans for breakthrough migraine.
My intensity and frequency of migraine have gone down from daily to once a week” I call that progress!
“I’ve taken Nurtec as an abortive and preventative, and it’s worked in both cases.
But I’d say it took a good month of taking it as a preventative before I thought it was really starting to work. I think I had a couple of migraines that first month but none since then”
Like the monthly preventive CGRPR inhibitors, Ajovy, Aimovig, Emgality, and Vyepti, Nurtec may also take a month or so to start working as preventive medicine.
“Nurtec does not work for me as an abortive unless I take it at the earliest sign of a migraine and it’s not a really bad one, then it takes like 6 hours to actually take the head pain away…sumatriptan works way better for me”.
“However, I did notice that when I’ve taken Nurtec as an abortive, I’m migraine free for the next 24-48 hours”
“So I think it might work for me as a preventive but unfortunately my insurance doesn’t recognize it as a preventative.
“I do still take it because of those migraine-free stretches it gives me and it allows me to break up some of my sumatriptan use”
“Nurtec worked awesome as an abortive for me (started working in 20min and I felt great the next day), and I take it every other day now for prevention.
“So Nurtec did nothing for me as an abortive. It has saved my life as a preventative along with Imitrex (Sumatriptan) as an abortive.
“I noticed cumulative effects. By about week 4-6, my cognitive function was mostly restored, which was my gauge at the time”.
“Does Nurtec take a while to start working or does it either work or not work altogether? My son has been on it as a preventative for over two weeks now.
Oddly, it seems to work as an abortive, but not as a preventative😢.
He has taken it twice now after the prodrome or visual aura started with complete relief (a triptan never did this so well), but his neuro started him on it every other day as a preventative and he can still get a migraine within an hour after taking it. I can’t figure it out”.
“I noticed cumulative effects increasing after 4-8 weeks. Most of my attacks respond to OTCs now, which had not been the case for years prior and my cognitive function is much better.
I switched to naratriptan for abortive because it was easier to keep prevention and acute separate in my mind”
“I agree it took a little time to work for me as a preventative. After about 6 weeks I could tell it was really working. It cut my migraine days from 12-15 a month to 4 or so!”
“I have been taking it for about 2.5 months now. The first month I took it as a rescue med and it didn’t really work. Hours later I still had a migraine.”
“It only worked if I took it and then could sleep for 30 mins to an hour, which is not very convenient. The next month I began taking it every other day as a preventive and it has been a Godsend.
In 1.5 months I have had only 2 mild migraines when I would have had about 20 by now.”
“Edit: Forgot to add that I have no side effects whatsoever”
“Nurtec has been a game-changer. I take it every other day for PREVENTION. My headache Dr told me they just approved this about a month ago.”
“It is so new that NURTEC WILL PAY FOR YOUR PRESCRIPTION. They are trying to prove its efficacy to the insurance companies I guess.”
“So I get mine free. My migraines have been reduced by about 80% I would say. Those dissolvables are worth their weight in gold for me. I wish you all the luck 🍀”
Nurtec for Migraine Prevention: People who found Nurtec USELESS!