Nurtec dosage, forms, and strengths

Nurtec ODT is a brand-name prescription drug prescribed to both prevent migraine attacks and treat an acute migraine attack. Its active ingredient is rimegepant, a calcitonin gene-related peptide receptor antagonist or CGRP inhibitor. It blocks a small molecule (CGRP) that causes many of the symptoms of a migraine headache. As a treatment for acute migraine, tablets are taken any time after the start of a migraine headache. To prevent migraines, people take a single Nurtec tablet every other day. Because it’s an orally disintegrating tablet, Nurtec has special dosing and storage instructions that are not typical of other tablets.

Nurtec forms and strengths

Nurtec is only available as an orally disintegrating tablet in a single dosage strength:

• Orally disintegrating tablets: 75 mg

Nurtec dosage for adults

Nurtec ODT is used to treat migraine headaches with or without aura or to prevent episodic migraines. Episodic migraine means that headaches occur on fewer than 15 days per month. As an acute treatment for migraine headaches, Nurtec is taken on an as-needed basis. For migraine prevention, Nurtec tablets are taken every other day. Since it’s available in only one strength, 75 mg, that’s the recommended dose no matter what it’s used for. 

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Nurtec dosage for acute treatment of migraine

Nurtec orally disintegrating tablets can be taken as needed to relieve the pain and other symptoms of an active migraine headache. As a CGRP inhibitor, Nurtec targets three processes that cause migraine pain and other symptoms: it reduces nerve inflammation, prevents the narrowing of blood vessels in the head, and blocks pain receptors. Do not take more than one 75 mg tablet every 24 hours. If that tablet does not work or the pain returns, take a second tablet 24 hours later. Do not take more than 18 tablets in a month. People prescribed Nurtec ODT for acute treatment of migraine may be prescribed one or two eight-tablet packets per month.

• Standard Nurtec dosage for the acute treatment of migraine: 75 mg orally disintegrating tablet taken as needed

• Maximum Nurtec dosage for the acute treatment of migraine: No more than one 75 mg tablet per 24-hour period and no more than 18 75 mg tablets per month

Nurtec dosage for migraine prophylaxis

Nurtec ODT is the only prescription drug the Food and Drug Administration (FDA) has approved as both an acute and a preventive treatment for migraines. As a preventive treatment, Nurtec’s mechanism of action is the same as treating an active migraine. The drug prevents blood vessel constriction, nerve cell inflammation, and the activation of pain receptors. As a preventive treatment, Nurtec orally disintegrating tablets are taken every other day. People prescribed Nurtec ODT for the prevention of migraines will be prescribed two eight-tablet packs per month. 

• Standard Nurtec dosage for the preventive treatment of migraine: 75 mg orally disintegrating tablet taken every other day

• Maximum Nurtec dosage for the preventive treatment of migraine: 75 mg orally disintegrating tablet taken every other day

Nurtec dosage for children

Nurtec ODT is not FDA approved for use in children or adolescents. 

Nurtec dosage restrictions

There are no dosage restrictions for people with mild to severe kidney problems (renal impairment) or mild or moderate liver disease (hepatic impairment). Healthcare providers are urged to avoid prescribing Nurtec to people with severe hepatic impairment or end-stage renal disease.

How to take Nurtec

Nurtec is prescribed for two different purposes. Dosing is different, so taking Nurtec only for the prescribed purpose is important. As an orally disintegrating tablet, taking a dose or storing the tablets is slightly more complex than normal tablets. Here are some general tips:

• Take this medication as instructed.

• Read and follow the patient instructions that come with this medicine. Talk to the prescriber or pharmacist if there are any questions.

• Only use this medicine for the purpose prescribed. Nurtec is not prescribed to both treat migraines and prevent migraines. It’s used for one or the other. If you need to switch to a different use of Nurtec, talk to the prescriber.

• If prescribed for acute treatment of migraine, only take a dose to relieve an active migraine. Do not take another dose of Nurtec ODT for 24 hours. Do not take Nurtec on an every-other-day schedule to prevent migraines. 

• If prescribed to prevent migraines, do not use a tablet to treat an acute migraine. You can take a dose during an active migraine if there’s a dose scheduled for that day. Otherwise, you can use any other acute migraine treatments like sumatriptan, provided that they are not CGRP inhibitors.

• Store the medicine in the sealed blister pack at room temperature.

To take a Nurtec ODT dose:

• Do not open the blister pack that contains the tablet until you are ready to take it.

• Make sure your hands are dry.

• Peel back the foil and gently remove the tablet from the blister pack. Do not push the tablet through the foil.

• Take the tablet immediately. Do not store it once the foil has been opened.

• Place the tablet on or under your tongue, where it will dissolve in seconds.

• You do not need to take Nurtec ODT with water.

Nurtec dosage FAQs

How long does it take Nurtec to work?

When used to treat an active migraine, Nurtec works quickly, providing significant symptom relief in about two hours. For the preventive treatment of episodic migraine, the maximum response takes two to six months to reach.

How long does Nurtec stay in your system?

Nurtec has a half-life of 11 hours, so it will take a little over two days to completely clear a dose from the body.

What happens if I miss a dose of Nurtec?

For treating active migraines, Nurtec is taken on an as-needed basis. It can be taken at any time during a migraine attack, so there’s no such thing as a missed dose. Just take it as long as there are migraine symptoms. Do not take more than one dose every 24 hours. Don’t take a dose after the migraine has passed.

For the preventive treatment of episodic migraine, Nurtec is taken every other day. A missed dose of Nurtec can be taken when remembered. However, two doses should not be taken in the same 24-hour period. So do not take the missed dose if the next dose is less than 24 hours away. In order to remember a dose, the manufacturer suggests creating a calendar reminder guide on a smartphone, smartwatch, or other app. Instructions can be found here.  

How long can you take Nurtec?

Nurtec can be taken for as long as it works and side effects are bearable. Nurtec may be discontinued if any allergic reactions are experienced. 

How do I stop taking Nurtec?

Nurtec can be stopped at any time without causing withdrawal symptoms or other problems. Before stopping, however, talk to the prescriber about your reasons for stopping. The prescriber may be able to offer medical advice about other treatment options.

What is the maximum dosage for Nurtec?

For Nurtec, the recommended dosage is the maximum dosage. For treatment of an active migraine, the recommended dose of Nurtec is one 75 mg tablet every 24 hours to a maximum of 18 tablets per 30-day period. For the preventive treatment of episodic migraine, the recommended dose is one 75 mg tablet every two days.

Can you overdose on Nurtec?

If too much Nurtec is taken, go to an emergency room immediately. The prescribing information does not list any symptoms typical of a Nurtec overdose. 

Besides taking too many Nurtec tablets in a day, another way to overdose is taking more than 18 doses in a 30-day period. That’s less serious of an overdose, but it may not be safe. If you need more than 18 doses of Nurtec in 30 days, talk to the prescriber about other treatment options.

What interacts with Nurtec?

Although Nurtec drug interactions are a concern, none are hazardous enough for any drug to be prohibited when someone is taking Nurtec. Healthcare professionals may choose to avoid certain drug combinations. Alternatively, they may monitor for side effects, make dosage adjustments of the other drug, or give you special instructions for taking Nurtec doses.

As with other CGRP inhibitors, healthcare providers are most concerned about drugs that block the body’s ability to eliminate Nurtec from the body. When Nurtec is combined with these drugs, its active ingredient, rimegepant, builds up in the bloodstream, increasing the risk of adverse effects. These drugs are either CYP3A4 inhibitors or P-gp inhibitors. They’re named after the two liver enzymes that break down rimegepant. Doctors, pharmacists, and other healthcare providers are knowledgeable about these drugs, so patients don’t need to look them up. You should know, however, that grapefruit has one of those problem substances. The prescriber may ask you to avoid eating grapefruit or drinking grapefruit juice while taking Nurtec.

Some drugs called CYP3A inducers speed up the body’s metabolism of rimegepant, so the body eliminates the drug more quickly. This makes Nurtec less effective at treating migraines. Some of these drugs, like the anticonvulsant phenytoin, the antibiotic rifampin, the corticosteroid dexamethasone, or the over-the-counter supplement St. John’s wort may need to be discontinued if you’re to benefit from Nurtec treatment.

What happens when you mix Nurtec and alcohol?

Alcohol is not prohibited when taking Nurtec. Keep in mind, though, that Nurtec can make you sleepy. Alcohol will add to the sleepiness. And alcohol may trigger a migraine in some people.

Can Nurtec be used with other migraine medications?

There are no restrictions on combining Nurtec with other migraine medications. This includes acute treatments and preventive treatments. However, Nurtec should not be taken with other CGRP inhibitors. 

Can Nurtec be prescribed as both an acute and preventive treatment for migraine?

No. Nurtec can only be prescribed either to treat the symptoms of an active migraine or to prevent migraine attacks. If there are issues with how Nurtec is prescribed, talk to the prescriber for medical advice about treatment options.

Is it safe to take Nurtec during pregnancy?

Although healthcare providers prescribe Nurtec during pregnancy, there are no studies about its safety during pregnancy. Animal studies using high doses at critical points in pregnancy have shown that it can cause congenital disabilities. Talk to your healthcare provider if you are pregnant or may become pregnant.

Is it safe to take Nurtec while breastfeeding?

Healthcare professionals do prescribe Nurtec to women who are breastfeeding. Studies have shown that very little rimegepant is present in human breast milk. No studies have been conducted concerning its effect on lactation or the possible effects of Nurtec on a nursing baby.

What are the side effects of Nurtec ODT?

Nurtec ODT causes very few adverse reactions. The most common side effect is nausea, which was reported by about 2% of participants in clinical trials. The most serious side effects are hypersensitivity reactions such as rash and trouble breathing. About 1% of clinical trial participants experienced allergic reactions like these.

Sources

• Nurtec ODT HCP site, Pfizer

• Nurtec ODT prescribing information, DailyMed, National Library of Medicine

• Nurtec ODT patient site, Pfizer

• Overview of Nurtec ODT for prevention of episodic migraine, Pharmacy Times