Qulipta vs. Nurtec ODT: The 6 Key Differences Between These Prescription Migraine Pills
Key takeaways:
Qulipta (atogepant) and Nurtec ODT (rimegepant) are prescription-only migraine medications. They work by interfering with a chemical messenger called calcitonin gene-related peptide (CGRP).
Qulipta is available as a standard tablet that you swallow. Nurtec comes as an orally disintegrating tablet (ODT) that dissolves on or under your tongue.
Qulipta has more possible side effects than Nurtec ODT, but Qulipta may be slightly more effective at preventing episodic migraines. Your healthcare provider can help you choose the best migraine medication for you.
There are ways to save on Qulipta and Nurtec ODT. If you’re eligible, manufacturer savings cards can help make your prescription more affordable. Patient assistance programs are also available.
Table of contents
Migraines are one of the leading causes of disability in the world. No matter if you have occasional migraines or experience them countless times per month, you know they can cause a significant disruption to your daily life.
The good news is there are many options for treating and preventing migraines. A newer class of medications — called calcitonin gene-related peptide (CGRP) receptor blockers — is effective in providing migraine relief. CGRP is a chemical messenger that can trigger migraines. And studies show people with migraines typically have higher levels of CGRP in their body.
Qulipta (atogepant) and Nurtec ODT (rimegepant) are two CGRP receptor blockers. They’re helpful remedies for addressing migraines, but some people may benefit from one more than the other. Here, we’ll highlight six key differences between Qulipta and Nurtec ODT.
1. Nurtec ODT is approved for migraine treatment and prevention
Qulipta and Nurtec ODT are prescription-only migraine medications for adults. But they’re FDA-approved for slightly different uses:
Qulipta is approved to prevent episodic and chronic migraines.
Nurtec ODT is approved to treat acute migraine attacks and prevent episodic migraines. It’s not approved to prevent chronic migraines.
Good to know: Episodic migraines are defined by experiencing 14 headaches or less in a month. Chronic migraines are defined by experiencing at least 15 headaches in a month.
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2. Qulipta comes as a standard tablet, unlike Nurtec ODT
Qulipta is available as a standard oral tablet. You can swallow it whole with a glass of water, similar to how many other oral medications are taken.
Nurtec ODT is a different type of tablet. It’s an orally disintegrating tablet (ODT). Instead of swallowing it whole, you let it dissolve in your mouth. You can place it on or under your tongue. This ODT is designed to dissolve quickly, which is convenient if you need in-the-moment relief from a migraine attack.
3. Qulipta and Nurtec ODT have different dosages
Qulipta and Nurtec ODT work in a similar way, but they have different dosages.
Medication | Available tablet doses | Usual dosage |
Qulipta | 10 mg 30 mg 60 mg | Episodic migraine prevention: 10 mg, 30 mg, or 60 mg by mouth once per day Chronic migraine prevention: 60 mg by mouth once per day |
Nurtec ODT | 75 mg | Acute migraine treatment: 75 mg by mouth as needed Episodic migraine prevention: 75 mg by mouth every other day |
Nurtec ODT is only available as a 75 mg tablet, so its dosages aren’t quite as flexible for episodic migraine prevention as Qulipta. What’s more, you shouldn’t take Nurtec ODT every day for migraine prevention. It’s better to take it every other day. It's not known if taking more than 18 doses in a 30-day period is safe.
Dosing for people with kidney problems
You may need to take a lower, 10 mg daily dosage of Qulipta if you have severe kidney problems and episodic migraines. But you should avoid it altogether if you have severe kidney problems and chronic migraines. Qulipta partially leaves your body through the kidneys, so higher doses could lead to extra side effects. Dosage adjustments aren’t necessary for people with milder kidney problems.
Nurtec ODT doesn’t require a dosage adjustment for kidney problems. Nurtec ODT may be a better choice if you’re aware of having any kidney problems.
Dosing for people with liver problems
If you have mild or moderate liver problems, you can take the standard dosage of either Qulipta or Nurtec ODT.
However, if you have severe liver problems, you shouldn’t take either one. This is because they’re metabolized (broken down) by the liver. Your chance of experiencing side effects from these medications goes up if you have serious liver problems.
4. Their effectiveness for managing migraines can vary
Qulipta and Nurtec ODT are effective at managing different types of migraine pain. But there’s some overlap when it comes to preventing episodic migraines.
In clinical trials, Qulipta was slightly more effective at preventing episodic migraines. People who took Qulipta had about 2 less migraine days per month compared with those taking a placebo pill. People who took Nurtec ODT had about 1 less migraine day per month compared with a placebo.
However, this data comes from different studies. There haven’t been any head-to-head studies to see which medication is more effective. Effectiveness can also vary from person to person, so talk with your healthcare provider to figure out the best option for you.
5. Their side effects aren’t exactly the same, either
Qulipta and Nurtec ODT are well tolerated. The most common side effect of both medications is nausea. But people who took Qulipta in clinical trials reported a few more side effects overall.
The percentages below represent how many people experienced each side effect in these studies.
Nausea (5-9%) Constipation (6-8%) Fatigue (4-5%) Decreased appetite (1-3%) Dizziness (2-3%) | Nausea (2-3%) Stomach pain or indigestion (2%) |
6. Qulipta and Nurtec ODT have different drug interactions
Qulipta and Nurtec ODT are metabolized by a specific enzyme in the liver (called CYP3A4). Other medications that affect this enzyme can cause Qulipta and Nurtec ODT to be metabolized faster or slower. Depending on the situation, this can lead to a less effective treatment or additional side effects. Your medication dosage(s) may need to be adjusted as a result.
The highest risk of interactions is with:
Oral antifungal medications such as ketoconazole
Seizure control medications such as phenytoin (Dilantin, Phenytek)
Antibiotics such as clarithromycin (Biaxin XL)
Different enzymes can affect Qulipta and Nurtec ODT, too. Qulipta is also metabolized by an enzyme called OATP. Nurtec ODT is metabolized by an enzyme called P-gp. These can lead to more interactions and potential dosage adjustments.
Other potential Qulipta interactions | Other potential Nurtec ODT interactions |
Rifampin (Rifadin) Gemfibrozil (Lopid) Ritonavir-containing medications like Paxlovid | Cyclosporine (Sandimmune) Amiodarone (Pacerone) Ranolazine (Ranexa) |
It’s important to note that not all possible interactions are listed here. Make sure your healthcare provider and pharmacist have an updated list of all medications and supplements you’re taking. This will help them check for interactions.
Can you switch from Qulipta to Nurtec ODT (or vice versa)?
Yes. You can switch from Qulipta to Nurtec ODT — or vice versa — if you get a new prescription from your healthcare provider. But you should only do this if you’re looking to prevent episodic migraines. The two medications are less comparable when it comes to migraine treatment and chronic migraine prevention.
Can you take Qulipta and Nurtec ODT together?
No. It’s not recommended to take Qulipta and Nurtec ODT together.
Qulipta and Nurtec ODT are both CGRP receptor blockers; they work in a similar way. Taking these medications together could increase your risk of side effects without any added benefit.
How to save on Qulipta and Nurtec ODT
Qulipta and Nurtec ODT are only available as brand-name medications. But GoodRx can help you navigate ways to save on your prescription.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Qulipta’s or Nurtec ODT’s patient assistance programs, which offer the medications at no charge.
Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Qulipta’s price is as little as $0 if you use the manufacturer’s savings card. Nurtec ODT’s price is also as little as $0 if you use the manufacturer’s savings card.
The bottom line
Qulipta (atogepant) and Nurtec ODT (rimegepant) are oral migraine treatments. They’re in the same class of medications, but they aren’t one and the same. Qulipta comes as a standard tablet, but Nurtec ODT dissolves on or under your tongue. And while Qulipta is designed to prevent episodic and chronic migraines, Nurtec ODT can treat acute migraines and prevent episodic migraines.
If you’re interested in learning more about Qulipta versus Nurtec ODT, talk to your healthcare provider or pharmacist. They can help you determine which migraine medication is best for you.
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References
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