Qulipta dosage, forms, and strengths

Qulipta is a brand-name prescription drug that prevents migraine headaches. Its active ingredient is atogepant, a drug that blocks a protein called calcitonin gene-related peptide (CGRP) from causing reactions, such as inflammation and the widening of blood vessels in the head , which contribute to migraine headache pain. As a preventive treatment, once-daily doses are taken for months or years to reduce the number of migraine headache days. The recommended dosage for chronic migraines is one 60 mg tablet daily.

Qulipta forms and strengths

Qulipta can only be taken in one oral dosage form: 

• Tablets: 10 mg, 30 mg, 60 mg

Qulipta dosage for adults

The Food and Drug Administration (FDA) has approved Qulipta as a preventive treatment for episodic migraine headaches and chronic migraine headaches in adults. The drug can be used in most people, but anyone who has had an allergic reaction to Qulipta can’t take the drug. Healthcare professionals may avoid using the drug in people with severe kidney disease or severe liver problems.

Check our best Qulipta prices

Qulipta dosage for episodic migraine

Healthcare professionals consider migraines to be episodic when people experience fewer than 15 migraine headache days in a month. Migraine headaches themselves are due to a cascade of events that start in the brain and eventually involve the blood vessels in the head.

The active ingredient in Qulipta is atogepant. It belongs to a class of drugs called calcitonin gene-related peptide (CGRP) receptor antagonists, or CGRP inhibitors for short. Calcitonin gene-related peptide is a protein and plays a key role in the onset of migraine headache pain and other symptoms. At some stage in a migraine headache, a prominent nerve in the head (the trigeminal nerve) releases a lot of CGRP. Blood vessels in the head dilate very quickly, causing headache pain. CGRP has other effects, such as inflammation, that also contribute to the pain, so it’s a major culprit implicated in migraine headache pain.

Daily doses of atogepant help to prevent migraine headaches by blocking the action of CGRP when it’s released into the body. Atogepant does not cure migraines, but it does reduce the number of headache days people experience each month. Doses are taken with or without food every day once per day.

• Standard Qulipta dosage for episodic migraine prevention: 10 mg, 30 mg, or 60 mg tablet taken once daily

Qulipta dosage for chronic migraine

Healthcare professionals diagnose chronic migraines in people who experience migraine attacks 15 or more times per month. Qulipta reduces the number of migraine attacks per month in people with chronic migraines in the same way it works for episodic migraines. The lower doses are not recommended. There is not much room for reducing the dose in people who need dosage modifications.

• Standard Qulipta dosage for chronic migraine prevention: 60 mg tablet taken once daily

Qulipta dosage for children

The FDA has not approved Qulipta for use in children. 

Qulipta dosage restrictions

The prescriber may reduce the Qulipta dose in people with kidney problems or who are taking drugs that slow down the body’s metabolism of atogepant. For the most part, healthcare professionals can reduce the dosage of Qulipta in people with episodic migraines. Lower doses may not be effective at preventing chronic migraines.

• Severe renal impairment or end-stage renal disease (creatinine clearance <30 mL/min): 10 mg per day for episodic migraines; avoid use for chronic migraines

• Severe hepatic impairment (Child-Pugh class C): Avoid use

How to take Qulipta

Taking Qulipta is relatively simple:

• Take Qulipta exactly as directed and do not use more than directed.

• Please read the Patient Information sheet that comes with the medicine.

• Qulipta can be taken with or without food.

• Swallow the tablet with a drink of water.

• If you can’t swallow a tablet, ask the prescriber for advice.

• Store Qulipta at room temperature out of the reach of children.

Qulipta dosage FAQs

How long does it take Qulipta to work?

Daily Qulipta doses significantly reduce monthly migraine days in the first twelve weeks of treatment. Monthly migraine attacks start to decrease in frequency during the first four weeks.

How long does Qulipta stay in your system?

Qulipta has a half-life of 11 hours. That’s how long it takes for the amount of drug in the body to be reduced by half. It will take slightly more than two days for the majority of a dose to be cleared from the body.

What happens if I miss a dose of Qulipta?

Take a missed dose as soon as possible. Skip the missed dose if it’s almost time for the next dose, and take the next normal dose as scheduled.

How long can you take Qulipta?

Qulipta is intended as a long-term preventive treatment that lasts months or years. People can continue taking Qulipta for as long as it works without causing intolerable side effects. In three 12-week clinical trials, researchers did not identify any significant side effects caused by daily use. 

How do I stop taking Qulipta?

Patients can stop taking Qulipta at any time without experiencing withdrawal symptoms, though they may start having more migraine attacks. To avoid more frequent migraines, talk to the prescriber before stopping. 

The prescriber has other options for migraine prophylaxis. These include other oral drugs like Qulipta (Nurtec ODT), monoclonal antibody injections that work like Qulipta (Aimovig), anti-seizure drugs, tricyclic antidepressants, and beta blockers. Lifestyle and dietary changes remain key components in preventing migraines no matter what drugs are used. 

What is the maximum dosage for Qulipta?

The maximum Qulipta dosage for episodic migraines is 60 mg daily. Qulipta dosage for chronic migraines is already at the maximum recommended human dose of 60 mg daily.

Can you overdose on Qulipta?

Call the prescriber or get medical attention if too much Qulipta is taken. There is no specific information about what happens when people overdose on Qulipta or other oral CGRP inhibitors.

What interacts with Qulipta?

Tell the prescriber about all drugs and supplements being taken. Some drugs can interact with Qulipta seriously enough to necessitate a dose change or the use of another migraine drug.

Qulipta’s most significant drug interactions involve drugs that slow down or speed up the body’s metabolism of Qulipta. If they slow it down, Qulipta will cause more side effects. If they speed it up, Qulipta won’t work well. Healthcare professionals call these drugs CYP3A4 inhibitors, OATP inhibitors, or CYP3A4 inducers. Dosage adjustments may be required.

Doctors will give a lower dose (10 mg daily) to people taking strong CYP3A4 inhibitors when used to prevent episodic migraines. Unfortunately, Qulipta can’t be used for chronic migraine with strong CYP3A4 inhibitors. Lower doses won’t help with chronic migraine for this interaction. Some of the strongest CYP3A4 inhibitors include antibiotics such as clarithromycin, and the antifungal drugs ketoconazole and itraconazole. 

Doctors will give lower doses (10 mg or 30 mg daily) to people taking OATP inhibitors like the immunosuppressant drug cyclosporine. They can give lower doses for both episodic and chronic migraines. 

For CYP3A4 inducers, the prescriber will increase the dose for episodic migraines but avoid Qulipta in people with chronic migraines. Some of these drugs, like the anticonvulsants phenytoin and carbamazepine, the antibiotic rifampin, or the over-the-counter supplement St. John’s wort, may need to be changed or discontinued.

Can Qulipta be used with other migraine medications?

People taking Qulipta can take other medicines that prevent migraines or abort active migraines. The prescriber will help design the most effective and safe treatment plan for preventing and treating migraines. 

What happens when you mix Qulipta and alcohol?

Alcohol does not seem to interact with Qulipta. However, some people experience dizziness or sleepiness when taking Qulipta. Adding alcohol to the mix may add to these symptoms.

Is it safe to take Qulipta during pregnancy?

Healthcare providers do not know if Qulipta is safe for pregnant women to take, but they aren’t prohibited from prescribing it. Animal studies did show that very high doses can cause problems in a fetus. Women who are pregnant or trying to get pregnant should ask the prescriber for medical advice.

Is it safe to take Qulipta while breastfeeding?

Healthcare providers aren’t sure if Qulipta is safe to take while breastfeeding. It hasn’t been studied in breastfeeding women, so they don’t know if it’s present in human breast milk, affects lactation, or can cause problems in a nursing infant. Women who are breastfeeding should discuss the possible risks with the prescriber. 

What are the most common side effects of Qulipta?

Qulipta’s most common side effects are nausea, constipation, fatigue, and sleepiness. People on lower doses may be less likely to experience problems. Qulipta may cause a temporary increase in liver enzymes, a sign that the liver is having problems. These usually resolve in two months after stopping. Weight loss is also a possible side effect.

What are the serious side effects of Qulipta?

The most serious side effects of Qulipta are hypersensitivity reactions, including skin rash, itchy skin, facial swelling, hives, and anaphylaxis, a potentially life-threatening reaction. Any serious reaction to the drug will require Qulipta to be discontinued.

Sources

• Qulipta atogepant tablet prescribing information, DailyMed (NIH National Library of Medicine)

• Qulipta, Abbvie

• Qulipta HCP, Abbvie

• Qulipta product monograph, AbbVie