Atogepant
QULIPTA
Pronunciation: a-TOE-je-pant (kyoo-LIP-ta)
“Cute lips & a toe(ga) pant”
What it isCGRP receptor antagonist; oral migraine prevention.
Why this oneA 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.
Atogepant prescription history
Animated chart of estimated U.S. prescriptions per year, Migraine-specific meds (1936–2026). Atogepant enters in 2021 (estimated).
FDA-approved for
- migraine prevention (2021)
Principal riskConstipation; CYP3A4-dependent
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.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| 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
Available strengths
- tab 10, 30, 60 mg
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
Cost
| Strength | #/mo | generic $/mo | brand $/mo | CostPlus | |
|---|---|---|---|---|---|
| 10 mg | tab | 30 qd | — | $1,150.75 | not offered |
| 30 mg | tab | 30 qd | — | $1,151.33 | not offered |
| 60 mg | tab | 30 qd | — | $1,153.48 | not offered |
Generic entry2039 est.
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Memory aids: interaction avatars
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Self-check
- Is atogepant for acute rescue?
No; preventive only. - Which two GI effects limit atogepant?
Constipation and nausea.