Gepants
- Small-molecule CGRP-pathway antagonists
- Acute migraine: ubrogepant/rimegepant/zavegepant
- Prevention: rimegepant/atogepant
- No vasoconstriction → useful if triptan unsuitable
- Generally nonsedating
- CYP3A/P-gp interactions matter for oral agents
- Medication-overuse signal appears lower than opioids
Class at a glance
- Small-molecule CGRP-pathway antagonists
Members / distinctions
- Prevention: rimegepant/atogepant
Pharmacology
- CYP3A/P-gp interactions matter for oral agents
Clinical role
- Acute migraine: ubrogepant/rimegepant/zavegepant
- No vasoconstriction → useful if triptan unsuitable
- Medication-overuse signal appears lower than opioids
Safety / monitoring
- Generally nonsedating
Pearls
- Rimegepant prevention: every other day; episodic migraine only
- Can raise BP; rare hypersensitivity
Self-check
- Why may gepants suit patients for whom triptans are unsuitable?
No vasoconstriction. - Which gepants are used for prevention?
Rimegepant and atogepant.
Drugs in this class (4)
Gepants prescription history
Animated chart of estimated U.S. prescriptions per year, Migraine-specific meds (1936–2026). Gepants highlighted from 2020.
All drug classes · Open Gepants in the interactive console ↗