Qulipta (Atogepant) – Oral

What Is Qulipta?

Qulipta (atogepant) is a medication option that's used to prevent episodic migraines in adults. It's in the calcitonin gene-related peptide (CGRP) receptor antagonist drug class.

Qulipta blocks the CGRP receptor (binding site) to prevent the attachment of the CGRP protein. The CGRP protein is thought to play a role in migraines by causing inflammation (swelling) of the meninges (protective layers that cover the brain). Migraines are less likely to occur if the CGRP protein can't bind to its binding site.

Qulipta is available as a prescription tablet. The Food and Drug Administration (FDA) hasn't assigned any black box warnings to this medication.

What Is Qulipta Used For?

Qulipta is a medication used to prevent episodic migraines in adults.

Migraines affect more than 29 million people in the United States)—most of whom (75%) are people assigned female at birth. Migraines are painful headaches that may last for hours or days and tend to occur on one side of your head. Migraine symptoms may also include nausea, vomiting, and light or sound sensitivity.

How to Take Qulipta

Take Qulipta once daily by mouth, with or without food.

Storage

After receiving Qulipta from the pharmacy, store your medication at room temperature, which is between 68 degrees and 77 degrees Fahrenheit. Temporarily storing in temperatures between 59 degrees and 86 degrees is permitted for short periods.

If you're planning to travel with Qulipta, become familiar with the regulations of your final destination. In general, however, make a copy of your Qulipta prescription. It's also a good idea to keep your medication in its original container from the pharmacy, with your name on the label.

What Are the Side Effects of Qulipta?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects with Qulipta include:

• Constipation
• Nausea
• Tiredness or lack of energy
• Decreased appetite
  

Severe Side Effects

The FDA doesn't include details about Qulipta's severe side effects on its label. If you think that you're experiencing life-threatening side effects, however, get medical help right away.

Long-Term Side Effects

Based on a 52-week clinical study, there were no safety concerns with Qulipta. More research, however, is needed.

Dosage: How Much Qulipta Should I Take?

Modifications

The following modifications (changes) should be kept in mind when using Qulipta:

Pregnancy: In animal studies, high doses of Qulipta were linked to negative effects on the unborn fetus. Not enough information is available about the safety and effectiveness of Qulipta in pregnant people. Ask your healthcare provider to weigh the benefits and risks of taking Qulipta during your pregnancy.

Breastfeeding: In animal studies, Qulipta was present in rats' breastmilk. The safety of Qulipta in human breastmilk is not known. Discuss with your healthcare provider the benefits and risks of taking Qulipta while nursing and different ways of feeding your baby while taking Qulipta.

People with kidney problems: If you have end-stage renal (kidney) disease (ESRD), your healthcare provider will usually recommend a maximum daily Qulipta dose of 10 milligrams (mg). If you're getting dialysis (a process that removes excess water and toxins from the blood), then take Qulipta after your dialysis appointment.

People with liver problems: If you have severe liver impairment, your healthcare provider will typically recommend avoiding Qulipta.

People taking other medications: Some medications interact with Qulipta. If necessary, your healthcare provider can change your daily Qulipta dose to prevent side effects or problems with how well it's working. If you have any concerns or questions about potential medication interactions with Qulipta, talk with your pharmacist or healthcare provider.

Missed Dose

If you accidentally forgot your Qulipta dose, take it as soon as you remember. If it's already close to your next scheduled dose, however, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Try to find ways to help yourself remember to routinely take your medication. If you miss too many doses, Qulipta might be less effective at preventing your migraines.

Overdose: What Happens If I Take Too Much Qulipta?

The FDA doesn't include details about overdose-related effects for Qulipta on its label. If you think that you're experiencing an overdose or life-threatening symptoms, however, seek immediate medical attention.

Precautions

What Are Reasons I Shouldn’t Take Qulipta?

The FDA doesn't include details about contraindication-related details for Qulipta on its label. Before taking Qulipta, however, talk with your healthcare provider if any of the following applies to you:

• Severe allergic reaction: If you have a severe allergic reaction to Qulipta or any of its ingredients, then Qulipta is not an ideal preventive option for your migraines. Talk with your healthcare provider for other options.
• Pregnancy: In animal studies, negative effects on the unborn fetus occurred with Qulipta. Not enough information is available regarding the safety and effectiveness of Qulipta in pregnant parents and on the unborn fetus.
• Breastfeeding: In animal studies, Qulipta was present in the breast milk of rats treated with Qulipta. Not enough is known, however, about the safety of Qulipta in human breast milk and its effect on nursing babies.
• Children: There are no safety and effectiveness studies for Qulipta in children.
• Adults over 65 years of age: A limited number of people over the age of 65 years have participated in clinical studies for Qulipta. As a result, there is not enough information about the safety and effectiveness of Qulipta in older adults vs. younger adults.
• People with liver problems: If you have severe liver impairment, Qulipta isn't recommended for you.
  

What Other Medications Interact With Qulipta?

Use caution when taking Qulipta with the following medications:

• CYP3A4-inhibiting medications: CYP3A4 is a protein in the liver that breaks down medications like Qulipta. CYP3A4-inhibiting medications—like the antibiotic Biaxin (clarithromycin)—prevent your liver's CYP3A4 proteins from breaking down medicines as well. Therefore, CYP3A4-inhibiting medications might raise the amounts of Qulipta in your body and increase your chances of side effects. As a result, your healthcare provider may lower your maximum Qulipta daily dose (e.g., to 10 mg) if you're taking strong CYP3A4-inhibiting medications.
• CYP3A4-inducing medications: CYP3A4-inducing medications—like Dilantin (phenytoin) for seizures—make CYP3A4 break down Qulipta more quickly and may lower Qulipta's effectiveness. Therefore, your healthcare provider might increase your daily Qulipta dose (e.g., to 30 mg or 60 mg) if you're taking moderate or strong CYP3A4-inducing medications.
• OATP-inhibiting medications: Your body's organic anion transporter proteins (OATP) help move medications—like Qulipta—around your body. Taking OATP-inhibiting medications—like Gengraf (cyclosporine) to prevent rejection of an organ transplant—can raise the amount of Qulipta in your body. Your healthcare provider may lower your daily Qulipta dose (e.g., to 10 mg or 30 mg) to prevent side effects.

For more detailed information about medication interactions with Qulipta, talk with your pharmacist or healthcare provider.

Also, tell your provider of all the medicines, supplements, and herbal or plant-based medicines you take. In addition to those mentioned above, taking certain medications, including the following, may require your provider to adjust your Qulipta dose:

• Intelence (etravirine)
• Nizoral (ketoconazole) 
• Rifadin (rifampin)
• Saint-John’s-wort
• Sporanox (itraconazole)
• Sustiva (efavirenz)
• Tegretol (carbamazepine)

What Medications Are Similar?

There are a number of CGRP-inhibiting medications used for migraines. Some CGRP inhibitors are biologics (made from naturally occurring sources—like proteins and sugars), while others are non-biologics (chemical-based). Qulipta is a non-biologic CGRP inhibitor.

The following medications are the most similar to Qulipta:

• Nurtec ODT (rimegepant)
• Ubrelvy (ubrogepant)

These medications—along with Qulipta—are also known as "gepants." There are no studies that compare different gepants yet. The following, however, include some interesting information about the different gepants:

• Qulipta is used to prevent migraines.
• Nurtec ODT can be used to prevent or treat migraines.
• Nurtec ODT can be placed on or underneath the tongue. You don't need to take it with water.
• Nurtec ODT and Ubrelvy shouldn't be used in people with end-stage renal disease (ESRD).
• Ubrelvy is only used to treat migraines.
• Ubrelvy can be used in people with severe liver impairment.

How Can I Stay Healthy While Taking Qulipta?

If you're taking Qulipta, chances are migraines have been affecting your quality of life. You've probably also tried a number of different medications. While living with migraines does have its challenges, there are ways to help improve your quality of life. The following are general tips:

• Take migraine-related medications as recommended by your healthcare provider.
• Consider keeping a migraine diary to become more aware of your migraine triggers.
• Achieve a healthy weight to prevent worsening migraines.
• Certain foods might trigger an active migraine. Avoid your food triggers. Consider working with a registered dietitian (RD) or registered dietitian nutritionist (RDN) to help you identify and manage any food triggers.
• Don't skip meals. Skipping meals might trigger an active migraine.
• Remember to warm up before exercise and drink enough water to prevent migraine attacks.
• Don't suddenly start intense or vigorous exercises, which may trigger a migraine. Slowly increase your exercise time and intensity.
• Find ways to manage your stress. Stress is a potential migraine trigger.
• Consider support groups or working with a mental health professional to help you find coping strategies to change the way you think, feel, react, or respond to living with migraines.
• Don't drive if you're experiencing an active migraine.