FDA Approves First Drug for Migraine Treatment and Prevention

For years, people who experience migraine headaches have had to choose between medications that can treat a current migraine or ones that prevent them altogether. Now, the Food and Drug Administration (FDA) has approved the first drug that can do both. 

The FDA initially approved rimegepant (Nurtec ODT) for acute use—to treat an existing migraine—in February of last year. On May 27, the FDA extended this approval for use in preventing migraines.

This marks an important advance in treating and managing migraine headaches, Merle Diamond, MD, medical director of the Diamond Headache Clinic in Chicago, tells Verywell.

“We have many new tools in our toolbox, and having a medication like Nurtec, which works great to get rid of an acute headache but also adds the benefit to be preventative," she says. "It gives patients a lot of flexibility."

Using Nurtec ODT to Treat Migraines

Migraines are a neurological condition, not just a bad headache. Many people who experience them report that the pain is accompanied or preceded by nausea, dizziness, changes in their vision, or sensitivity to sound, light, and smell.

This condition affects 39 million people in the United States and one billion worldwide, according to the Migraine Research Foundation.

“I think it's really important to emphasize that migraine disease is the second most disabling condition worldwide,” Diamond says. “The only condition more disabling than migraine is back pain.”

Nurtec ODT is approved for use in people with episodic migraines, who experience migraines a few times each month. When migraines occur more than 15 times in a month, they're considered chronic.

If a person is treating a current migraine, they should take Nurtec ODT once a day. As prevention, people should take it once a day every other day, Diamond says. Nurtec ODT is an oral dissolving tablet that you place on or under the tongue, where it dissolves without the need for liquids.

Once it's in your system, Nurtec ODT targets the CGRP receptor in the brain, which plays a key role in causing migraines. The medication can treat a current migraine within two hours and will help prevent it from returning for up to 48 hours.

Side effects of the medication include:

• Nausea
• Hypersensitivity (including shortness of breath and severe rash)

The drug is available only by prescription.

How to Prevent a Migraine

There are many medications and products available to help people prevent their migraines, Diamond says. In addition to medications, there are nerve stimulating devices that help relieve pain.

“The good news for patients is they're not stuck with a therapy that's been around for 50 years that helps but has a lot of side effects,” she says. Many of these newer treatments were created specifically for migraines and not just for headaches in general. Like Nurtec ODT, they have very few side effects, she says.

Often, patients can predict when they are about to have a migraine, Diamond says. In that case, they can take medication or use a nerve stimulating device in advance.

A hectic week at work or a trip that changes your usual eating patterns can set off a migraine, she adds. Hormonal changes during the menstrual cycle can also trigger migraines in women who experience them.

“You can use Nurtec during those times to help prevent those headaches, or you could consistently take it every other day, just as a regular preventive," she says. “The goal is no disability. The goal is ‘I suffer from migraine disease, but I can go do the things I need to do today,’ and this gives patients a really good option.”