Nurtec ODT for Patients With Migraines: Side Effects, Drug Interactions, and Cost Savings

Our easy-to-read fact sheets provide clinicians with reliable information to share with patients and their caregivers. 

A migraine is a common type of primary headache, often presenting as throbbing in one particular area of the head.¹ Migraine headaches may present with accompanying symptoms, such as sensitivity to light and/or sound as well as potential nausea and vomiting. Migraines can be classified into 2 subtypes: episodic migraines with or without aura and chronic migraines. Chronic migraines are less common. Aura headaches are associated with short and reversible sensory, visual, speech, brainstem, motor, or retinal symptoms.¹

Therapeutic Options for Migraines

There are many options available for acute and preventative treatment of migraines. Acute migraine therapy aims to provide relief from a migraine as symptoms are being experienced. When administered as early as possible, these agents return the patient’s ability to function at more successful rates.¹

Common therapies for acute migraine include:²

• Acetaminophen (Tylenol®) and non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, diclofenac, and naproxen
• Triptans, including almotriptan, eletriptan (Relpax®), frovatriptan (Frova®), naratriptan (Amerge®), sumatriptan (Treximet®), zolmitriptan (Zomig®), and rizatriptan (Maxalt®)

Recently, the US Food and Drug Administration (FDA) approved 3 drugs in 2 new drug classes for patients with cardiovascular disease that cannot use triptans:²

• Ditans: lasmiditan (Reyvow®)
• Gepants: ubrogepant (Ubrelvy®) and rimegepant (Nurtec ODT®)

Reyvow, Ubrelvy, and Nurtec orally disintegrating tablets (ODTs) can be used for the acute treatment of migraine with or without aura in adults. Nurtec ODT is also used for the preventive treatment of episodic migraine in adults.²

How to Take Nurtec ODT

Nurtec is approved for the acute treatment of migraine attacks with or without aura as well as for the preventative treatment of episodic migraines. Nurtec falls into a drug class known as calcitonin gene-related peptide (CGRP) receptor antagonists. During episodes of migraine headaches, CGRP levels are elevated. By inhibiting CGRP signaling, migraine episodes can be prevented to decrease the rate of headaches and provide relief.³ It also helps to stop pain signals and inflammation occurring in the brain.

Nurtec is available as a 75 mg ODT. Patients should take Nurtec as indicated by their health care provider. 

For the acute treatment of migraine attacks when they occur, Nurtec may be taken 1 time daily, as needed. For preventative treatment, take Nurtec 1 time every other day. You should not take more than 1 tablet in 24 hours. Nurtec should be limited to 18 doses in 30 days, as safety beyond this threshold remains unknown.⁴

Nurtec comes in a blister pack consisting of 8 tablets. These tablets should be stored in their original packaging at all times. Do not store any of the tablets outside of the blister pack for future use. Patients must ensure that their hands are dry when opening the blister pack.

Begin by peeling the back cover of 1 blister and gently remove the tablet, it should not be pushed through the foil. The dosage must be taken immediately after the blister is removed. Place the tablet on or under your tongue. Nurtec is an ODT so it will dissolve on its own without the need for additional liquid.⁴ 

Side Effects of Nurtec ODT

The most common side effect reported with Nurtec is nausea. Other less common side effects include abdominal pain, indigestion, difficulty breathing, and severe rash.⁴

Nurtec ODT may also cause more serious side effects, such as allergic reactions. Patients must call their doctor or seek immediate medical attention if they experience any of the following symptoms associated with allergic reactions:⁴

• Swelling of the face, mouth, tongue, or throat;
• Trouble breathing;
• Rash or hives; or
• Tightness in the chest or throat.

Contraindications and Precautions of Nurtec ODT

Nurtec ODT is not recommended for patients with a history of a severe allergic reaction to any of the components of the medication. Nurtec is not recommended for patients with severe liver impairment or end-stage renal disease. Patients who are pregnant or breast-feeding must notify their doctor before initiating treatment. There is currently no data on the developmental risks associated with the use of Nurtec for pregnant women or breastfed infants. Your health care provider will assess the benefits and risks when selecting your therapy.⁴

Frequently Asked Patient Questions

How can I manage the side effects I may experience while taking Nurtec ODT?

Common side effects associated with Nurtec ODT include nausea, abdominal pain, and indigestion.⁴ It is important to follow all directions when taking Nurtec to reduce the risk of side effects. Make sure to inform your health care provider of all medications you are taking as well as all medical conditions, to avoid any interactions. Take only 1 dose of Nurtec each day and do not exceed more than 18 doses in a month. Avoid taking Nurtec with grapefruit or grapefruit juice. 

If you are experiencing nausea or abdominal pain with Nurtec, you may take your dose of Nurtec with food. Be sure to drink fluids in small amounts. Certain anti-nausea medications may help to relieve your side effects. If these symptoms persist, tell your doctor. If you are experiencing indigestion, speak with your health care provider about using antacids to ease any pain. When experiencing any signs of an allergic reaction, stop taking Nurtec immediately and seek medical attention.

How fast does it take for Nurtec ODT to begin working?

Nurtec ODT can provide migraine relief in as little as 1 hour. A study with 1351 patients evaluated the efficacy of Nurtec ODT in relieving migraine symptoms. Patients were separated into 2 groups: one taking Nurtec ODT and the other taking placebo. Within 1 hour, 37% of patients taking Nurtec had pain relief compared with 31% of patients taking placebo. Normal function returned in 22% of patients taking Nurtec compared with 16% of patients taking placebo. At 2 hours, 35% of patients taking Nurtec had freedom from bothersome symptoms compared with 27% of patients taking placebo.⁵ 

Another study consisting of 695 patients, 348 taking Nurtec and 347 assigned placebo, evaluated the efficacy of Nurtec as a preventative treatment. At 12 weeks, patients taking Nurtec expressed significantly reduced monthly migraine days in comparison to placebo.⁶

Can I take Nurtec ODT with other preventative medications for migraines?

Nurtec ODT is indicated for both acute and preventative treatment of migraines. When used for acute treatment of migraines, Nurtec ODT can be combined with other preventative treatments as long as their mechanism is different from Nurtec ODT. Ubrelvy is an example of a medication patients cannot take at the same time as Nurtec ODT. When used for preventative treatment, Nurtec ODT may also be used with other acute migraine treatments with different mechanisms of action. Consult with your health care provider to decide which treatment plan is right for you.

Will Nurtec ODT interact with any of my other medications?

It is important to notify your doctor of any other medications, over the counter products, or vitamins you are taking before starting on Nurtec ODT. Some of your medications may not be taken with Nurtec ODT as they can disrupt its serum concentration. If any of your current medications fall under the categories of CYP3A4 inducers or inhibitors, avoid combination with Nurtec ODT.⁴

Let your doctor know if you have taken any of the following drugs within the last 48 hours: amiodarone, cyclosporine, lapatinib, quinidine, or ranolazine. These medications are known as P-glycoprotein (P-gp) inhibitors and may increase the serum concentration of Nurtec ODT.⁴ 

Some other common medications that interact with Nurtec ODT include:⁴

• Antibiotics, such as clarithromycin or ciprofloxacin;
• Antifungals, such as ketoconazole or itraconazole;
• Anticonvulsants, such as phenytoin or phenobarbital;
• Cyclosporine;
• HIV medications, such as ritonavir, cobicistat, or indinavir;
• Heart medications, such as diltiazem and verapamil; and
• St. John’s Wort.

Interactions are not limited to this list and must be discussed with your health care provider.

Does Nurtec ODT have any manufacturer coupons available to help make it more affordable?

The Nurtec website offers valuable information and resources regarding affordable access to your Nurtec ODT prescription. Once your health care provider writes your prescription, they can help connect you to their service, Nurtec OneSource. A representative will then reach out to you to help you enroll and start receiving their benefits. Through Nurtec OneSource, patients are offered home deliveries, savings and out-of-pocket support, virtual doctor visits, and personalized help.⁷

Some patients may prefer to pick up their prescription at their local pharmacy. The Nurtec website allows you to sign up for a copay card by filling out a simple form on their website. Patients 18 years of age or older who have private or commercial health insurance may pay as little as $0 for a 30-day supply. You must be 18 years of age or older to sign up. It is important to note that this card is not health insurance and will only be accepted at participating pharmacies.⁷

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