Ubrelvy (Ubrogepant) - Oral

What Is Ubrelvy?

Ubrelvy (ubrogepant) is a calcitonin gene-related peptide (CGRP) receptor antagonist used to treat migraines in adults. It does not prevent migraines from occurring but helps treat acute migraine attacks.

CGRP is a protein present in neurons in the trigeminal ganglion (part of the trigeminal nerve) that causes pain and inflammation. During a migraine attack, CGRP is present at higher levels than usual. Ubrelvy improves migraine symptoms by blocking the activity of CGRP.

This medication is available by prescription as an oral tablet.

What Is Ubrelvy Used For?

The Food and Drug Administration (FDA) approved Ubrelvy to treat acute migraine with or without aura in adults. Generally, typical migraine symptoms can include:

• Severe headache
• Neck or shoulder pain
• Nausea
• Inability to tolerate light or sounds
• Vomiting

Migraines with aura are different from other migraines in that they are characterized by visual or sensory disturbances before the migraine starts.

Ubrelvy should not be used as a preventative treatment of migraines. The safety and efficacy of Ubrelvy have not been established in children and adolescents.

How to Take Ubrelvy

Take Ubrelvy with or without food. It is important to take Ubrelvy at the first signs of migraine. Most people can take a second tablet two hours later if migraine symptoms have not resolved, but do not exceed two tablets within a 24-hour period.

While taking Ubrelvy, keep track of how often you are taking the medication and when your migraines occur to determine how well the medicine is working.

Storage

Store Ubrelvy tablets at room temperature (between 68 degrees and 77 degrees Fahrenheit), and protect them from light and moisture. 

What Are the Side Effects of Ubrelvy?

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 1-800-FDA-1088.

Common Side Effects

The most common side effects of Ubrelvy can include nausea and tiredness.

Dosage: How Much Ubrelvy Should I Take?

Modifications

Safe use of Ubrelvy in pregnancy has not been established, and there are no published reports of its use in pregnancy. The decision to use Ubrelvy while pregnant should include a consideration of the benefits and potential risks to the pregnant person and fetus. 

It is unknown whether Ubrelvy is excreted in human breast milk, and there are no published reports of use during breastfeeding. It is a highly protein-bound drug, so milk levels of the drug are likely low. It is likely OK to take while breastfeeding an older infant, though an alternative drug may be preferred while nursing a preterm or newborn infant.

Clinical trials of Ubrelvy did not include a large number of older adults (aged 65 years and older) to determine if there is a difference in safety or efficacy in this population. In general, older individuals may need to start at the lower dose range.

Missed Dose

Ubrelvy should be taken only when you have a migraine; not on a regular basis. Therefore, missing doses should not be an issue.

Overdose: What Happens If I Take Too Much Ubrelvy?

Overdoses of Ubrelvy should be treated symptomatically. Overdose symptoms are expected to be similar to adverse effects and may include nausea, sedation, fatigue, and dry mouth.

Precautions

What Are Reasons I Shouldn’t Take Ubrelvy?

Do not take Ubrelvy if you are also taking a medication known to be a strong inhibitor of cytochrome P450 3A4 (CYP3A4). These medications include ketoconazole, itraconazole, and clarithromycin, among others.

What Other Medications Interact With Ubrelvy?

Ubrelvy may interact with medications that are known as inhibitors or inducers of CYP3A4.

Drug interactions may occur if you take Ubrelvy with the following:

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, grapefruit juice): These medications result in increased exposure to Ubrelvy and should not be taken together. 
• Moderate CYP3A4 inhibitors (e.g., verapamil, cyclosporine, ciprofloxacin, fluvoxamine, fluconazole): Moderate CYP3A4 inhibitors increase exposure to Ubrelvy and require a dose adjustment. Therefore, use the lower strength of Ubrelvy and do not take a second dose within 24 hours of the first dose. 
• Strong CYP3A4 inducers (e.g., rifampin, barbiturates, phenytoin, St. John’s wort): These medications result in lower exposure to Ubrelvy and likely reduce its efficacy. So, if you take strong CYP3A4 inducers, you should use an alternative migraine treatment. 
  

What Medications Are Similar?

Ubrelvy is a CGRP receptor antagonist that should not be combined with other CGRP receptor antagonists. This family of medications is also referred to as “Gepants”. Other CGRP receptor antagonists include:

• Qulipta (atogepant): Approved for migraine prevention
• Nurtec (rimegepant): May be used for the prevention and acute treatment of migraines

How Can I Stay Healthy While Taking Ubrelvy?

Keep a headache log after starting Ubrelvy to track how often you are taking it and whether you need a second dose. Do not take more Ubrelvy than recommended by your healthcare provider. Taking medication to treat migraines more than about 10 days per month can lead to medication overuse headaches. 

If you find yourself having headaches frequently, talk to your healthcare provider to see if taking a daily medication like a beta-blocker may be helpful for preventing migraines.