EAN 2023 | How to integrate gepants into migraine clinical care

Gepants are wonderful new drugs that have just been out for the last couple of years for the acute care and prevention of migraine. My talk with two other doctors is about their use in acute care and prevention of migraine. Many people are given triptans for the acute care of migraine and when one or certainly two triptans have failed or caused side effects, we think about going to a gepant next. And that’s similar to what the guidelines are in most countries. Well, the good news about rimegepant, which is also called Nurtec in the United States and possibly elsewhere, is that it’s the only drug for migraine that can be used both acutely and preventively. Which makes it a very special drug because you can give it for prevention, one 75 milligram ODT (orally disintegrating tablet) every other day for prevention, but if the patient has a headache on the off day, they can take it again there. There is another drug that’s just for prevention, and there is another drug which is just for acute care, and they work well too. They have passed the FDA guidelines, and they don’t have too many side effects either. But there’s something very special for me to be able to say to a patient, well, you’re going through an exam period right now, so I want to start you on this drug preventively for migraine. And it works very quickly within the first week and then a week or two later when they don’t need it as much, they can just stop it. And I can use it acutely also and it works very quickly, beginning to work for many patients within 15 minutes or so.