How Does Nurtec ODT Work? All About Nurtec’s Mechanism of Action

If you’ve ever experienced a migraine, you know how painful and disruptive they can be. But there are several options available to treat and prevent migraines. Nurtec ODT (rimegepant) is a newer type of medication that targets a migraine pathway in your brain. Because of how it works, it can be used for both migraine treatment and prevention.

It’s natural to have questions about how Nurtec ODT works. Below is everything you need to know about the way it works, when to take it, and when it starts working.

Good to know: In this article, we’ll refer to Nurtec ODT as “Nurtec” for ease of reading. ODT stands for orally disintegrating tablet, the type of pill that Nurtec comes as. ODTs dissolve quickly in the mouth without needing water. This can be especially helpful if your migraines cause nausea or vomiting.

How does Nurtec work?

Nurtec is a calcitonin gene-related peptide (CGRP) receptor antagonist. It works by blocking the binding sites of CGRP — a protein the nerves in your brain release that can trigger migraines. When you take Nurtec, it prevents CGRP from attaching to its binding sites. Without a place for CGRP to latch onto, its effects are less.

To understand why blocking CGRP helps mitigate migraines, we need to explain exactly what CGRP’s effects are. Generally, it plays a role in causing the pain and other symptoms you may feel during a migraine attack. More specifically, CGRP does this in a few different ways, such as:

• Vasodilation: CGRP widens the blood vessels in your brain (vasodilation).

• Inflammation: CGRP triggers certain cells in your brain to release chemicals that cause swelling (inflammation).

• Pain signaling: CGRP causes the nerves in your brain to become more sensitive to vasodilation and inflammation. This makes your nerves more sensitive to pain.

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Nurtec doesn’t stop your body from making or releasing CGRP. But it does help block CGRP from causing these effects. This can reduce the pain and other symptoms that come with a migraine. It can also help prevent migraines if you take it regularly (more on this below).

What types of migraines can Nurtec treat?

Most migraines share similar symptoms, but there are different types of migraines. You can take Nurtec in two different ways to treat common types of migraine.

You can take Nurtec as needed to treat migraine without aura or migraine with aura. These are the most common types of migraine. Migraine auras are visual or physical symptoms that happen shortly before an attack starts. Common aura symptoms include vision changes, seeing flashing lights, and mixing up words.

Migraines (with or without aura) can cause intense pain, often located on one side of the head. They can last from a few hours to several days and may be accompanied by nausea, vomiting, and sensitivity to light or sound.

You can also take Nurtec regularly to prevent episodic migraines. These are migraines that happen frequently, but for less than 15 days per month. People with episodic migraines experience migraine episodes that can last from a few hours up to 3 days. But they also have periods without migraines in between.

How long does it take Nurtec to start working?

Nurtec treats migraines quickly, but it takes longer for Nurtec to prevent them.

EXPERT PICKS: WHAT TO READ NEXT

• Tips for taking Nurtec ODT: Learn how to dissolve Nurtec ODT (rimegepant) in your mouth the right way, along with other tips for taking it.

• What side effects are possible while taking Nurtec ODT? Here are common and rare Nurtec ODT side effects to consider, as well as tips for how to manage them.

• Nurtec ODT alternatives: Nurtec ODT is one of many medications in its class. Read more about CGRP antagonists and how they differ from each other.

When taking Nurtec to treat a migraine, many people experience relief within about 2 hours. Keep in mind, it may take a little longer depending on what you’ve eaten. High-fat meals can slow down how fast Nurtec works.

If you’re taking Nurtec to prevent migraines, expect to see results after a few weeks of treatment. In studies, Nurtec’s effectiveness was measured after 9 to 12 weeks (about 3 to 4 months). But some people may notice improvement about 1 week after starting it. Keeping a migraine diary can help you track how well Nurtec is working to prevent your migraines.

When should you take Nurtec?

Your Nurtec dosage depends on whether you’re taking it for migraine treatment or prevention.

If you’re taking Nurtec to treat a migraine, dissolve 1 tablet (75 mg) in your mouth as soon as you start to notice symptoms. This can include symptoms you feel during the prodrome or aura phase. These are phases that happen before your migraine starts. Don’t take more than 1 tablet in a 24-hour period. And don’t take more than 18 tablets per month.

If you’re taking Nurtec to prevent migraines, dissolve 1 tablet in your mouth every other day. Any time of the day is fine, but try to take it about the same time of day. Helpful tips to remember your dose include using medication reminder apps and setting an alarm.

What should you do if Nurtec isn’t helping your migraines?

Talk to your prescriber if Nurtec doesn’t seem to be helping your migraines. Medications like Nurtec may not be helpful for everyone. So it’s important to discuss all treatment options with a healthcare professional and find one that works well for you.

Remember to give Nurtec enough time to work. And be sure to stay within the maximum treatment dosage of 1 tablet per day and 18 tablets per month. Taking more than recommended can potentially lead to rebound (overuse) headaches.

If you’re taking Nurtec for migraine prevention, you’ll likely also have a medication available to treat migraines if they happen. This medication should be something that works differently from Nurtec, such as a triptan medication. Your prescriber can help determine the best combination of medications for you.

How to save on Nurtec

There are ways to save on Nurtec, which is available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $0 per month for Nurtec using a copay savings card from the manufacturer.

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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