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CGRP Receptor Antagonist (Gepant — Migraine Prevention)

Atogepant

Brand names: Aquipta

An orally active calcitonin gene-related peptide (CGRP) receptor antagonist ('gepant') used for the preventive treatment of migraine in adults with frequent attacks.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It blocks the CGRP receptor, antagonising the vasodilatory and pro-nociceptive actions of CGRP that are central to migraine pathophysiology.

Prescribing in practice

  • It should be reserved for migraine prophylaxis in line with NICE criteria, typically after previous preventive treatments have been unsuitable or ineffective.
  • Dose adjustment and caution apply with strong CYP3A4 inhibitors or inducers and in significant hepatic or renal impairment, so check current prescribing references.
  • Common adverse effects include nausea, constipation and fatigue, and response should be reviewed to confirm continued benefit.

Monitoring

No routine laboratory monitoring is required; monitor migraine frequency to assess response and review the need to continue after an adequate trial.

Counselling the patient

  • This medicine is taken regularly to prevent migraines, not to treat an attack in progress.
  • Report troublesome constipation, nausea, or tiredness.
  • Keep a headache diary to help judge whether it is working.

Evidence & guidelines

Use is supported by NICE technology appraisal guidance on atogepant for preventing migraine.

Reference: NICE TA913 (Atogepant for preventing migraine, 2024); ADVANCE trial (NEJM 2021); BASH UK Migraine Guidelines (2023); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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