CGRP receptor antagonist (gepant)
Rimegepant
Brand names: Vydura
Adult dose
Dose: Acute migraine: 75mg ODT PRN. Prophylaxis: 75mg every other day
Route: PO (orodispersible)
Frequency: PRN or alternate-day
Clinical pearls
- Acute and preventive migraine; suitable for cardiovascular risk (no vasoconstriction unlike triptans)
- Per NICE TA919
Contraindications
- Severe hepatic impairment
- Concurrent strong CYP3A4 inhibitors
- Hypersensitivity
Side effects
- Nausea
- Hypersensitivity (incl. dyspnoea, rash)
Interactions
- Strong CYP3A4 modulators
- P-gp inhibitors
Monitoring
- Symptoms
Reference: BNF; NICE TA919; SmPC; https://bnf.nice.org.uk/drugs/rimegepant/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS