Atogepant
QULIPTA
What it isCGRP receptor antagonist; oral migraine prevention.
Why this oneIt is a preventive-only gepant rather than an acute rescue drug, distinguishing it from ubrogepant and rimegepant.
What limits itConstipation and nausea limit use. CYP3A4 interactions and prior authorization commonly change prescribing.
FDA-approved for
- migraine prevention (2021)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Preventive treatment of episodic migraine | Adults | 10, 30, or 60 mg QD | 10–60 mg QD | 60 mg QD |
| Preventive treatment of chronic migraine | Adults | 60 mg QD | 60 mg QD | 60 mg QD |
Renal Severe impairment or ESRD (CLcr <30): episodic migraine 10 mg QD, chronic migraine not recommended; no adjustment for mild/moderate
Hepatic No adjustment for mild/moderate; avoid in severe hepatic impairment
Instructions
- Take orally with or without food
- Dosage modifications with CYP3A4 inhibitors/inducers and OATP inhibitors
Cautions
- Hypersensitivity reactions (anaphylaxis, dyspnea) — can occur days after dosing
- New-onset or worsening hypertension
- New-onset or worsening Raynaud's phenomenon
Adverse reactions
- Nausea
- Constipation
- Fatigue/somnolence
- Decreased appetite
- Dizziness
Pregnancy No adequate human data; animal studies show adverse developmental effects at high exposures; registry available
Lactation Excreted in breast milk in low amounts (relative infant dose ~0.19%); weigh benefits and risks
NO BOXED WARNINGS
Principal riskConstipation; CYP3A4-dependent
Cost, est. cash$500–$1,200/month
Generic entry2039 est.
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityAgent-specific vascular, serotonergic or hepatic risks; acute overdose is usually limited outside ergot or cardiovascular agents.
Mechanism of action: Atogepant ballicule
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