What are the new drugs for the treatment of migraines?
- Migraine Treatment
The newest novel drug (approved March 9, 2023) for the treatment of migraine is Zavzpret (zavegepant) nasal spray. - Migraine Prevention
The newest drug (approved September 28, 2021) for the prevention of migraine (episodic migraine) is Qulipta (atogepant).
New drugs for the treatment of migraine
- The newest drug for the acute treatment of migraine is Zavzpret (zavegepant) nasal spray.
- The newest oral drugs for the acute treatment of migraine are Nurtec ODT (rimegepant) and Ubrelvy (ubrogepant), both orally-administered calcitonin gene-related peptide (CGRP) receptor antagonists (gepants).
- Another new drug for the acute treatment of migraine is Reyvow (lasmiditan), the first serotonin (5-HT)1F receptor agonist.
- The other new drugs for the acute treatment of migraine are novel formulations of older drugs such as sumatriptan and rizatriptan, belonging to the class of drugs called serotonin (5-HT) receptor agonists (triptans), and dihydroergotamine, an ergotamine derivative.
- Sumatriptan is a well-established migraine treatment first approved in subcutaneous injection form under the brand name Imitrex in 1992. Sumatriptan is available in a variety of dosage forms, including injection, oral tablets, nasal spray, and nasal powder. Some formulations are also available as generics.
- Rizatriptan was first approved in an oral tablet formulation under the brand name Maxalt, and an orally disintegrating tablet formulation under the brand name Maxalt-MLT in 1998. Both dosage forms are available as generics. An oral film formulation of rizatriptan was approved under the brand name RizaFilm in 2023.
- Dihydroergotamine was first approved in injection form under the brand name D.H.E. 45 in 1946 and as a nasal spray under the brand name Migranal in 1997. Some dihydroergotamine formulations are also available as generics.
The following drugs are FDA approved for the acute treatment of migraine with or without aura in adults.
| Drug Name | FDA Approval | Company | Drug Class | Dosage Form | Administration |
|---|---|---|---|---|---|
|
RizaFilm (rizatriptan) |
April 14, 2023 | IntelGenx Corp. | serotonin (5-HT)1B/1D receptor agonist (triptan) | oral film |
as needed; adults may take a second 10 mg dose at least 2 hours after the first dose if needed, but no more than three 10 mg oral films can be taken in a 24 hour period |
|
Zavzpret (zavegepant) |
March 9, 2023 | Pfizer Inc. | calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) | nasal spray |
as needed; a dose (10 mg into one nostril); no more than one dose to be taken in 24 hours (the safety of taking more than 8 doses in a 30-day period has not been established) |
|
Trudhesa (dihydroergotamine mesylate) |
September 2, 2021 | Impel NeuroPharma, Inc. | ergotamine derivative | nasal spray |
as needed; a dose (0.725 mg into each nostril) may be repeated a minimum of 1 hour after the first |
| Nurtec ODT (rimegepant) | February 27, 2020 | Biohaven | calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) | orally disintegrating tablets |
as needed; no more than one dose (75 mg) to be taken in 24 hours |
|
Ubrelvy (ubrogepant) |
December 23, 2019 | Allergan plc | calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) | oral tablets |
as needed (a second dose may be administered at least 2 hours after the initial dose); no more than 200 mg to be taken in 24 hours |
| Reyvow (lasmiditan) | October 11, 2019 | Eli Lilly and Company | serotonin (5-HT)1F receptor agonist (ditan) | oral tablets |
as needed; no more than one dose to be taken in 24 hours |
| Tosymra (sumatriptan) | January 25, 2019 | Dr. Reddy’s Laboratories Limited | serotonin (5-HT)1B/1D receptor agonist (triptan) | nasal spray |
as needed; no more than 30 mg to be taken in 24 hours (doses separated by at least one hour) |
| Zembrace SymTouch (sumatriptan) | January 28, 2016 | Dr. Reddy’s Laboratories Ltd. | serotonin (5-HT)1B/1D receptor agonist (triptan) | subcutaneous injection |
as needed; no more than 12 mg to be taken in 24 hours (doses separated by at least one hour) |
| Onzetra Xsail (sumatriptan) | January 27, 2016 | Avanir Pharmaceuticals, Inc. | serotonin (5-HT)1B/1D receptor agonist (triptan) | nasal powder |
as needed; no more than two doses (44 mg) to be taken in 24 hours (doses separated by at least two hours) |
Related Questions
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New drugs for the prevention of migraine
The newest drugs for the prevention of migraine belong to the class of drugs called calcitonin gene-related peptide (CGRP) antagonists and include Aimovig, Ajovy, Emgality, Vyepti, Nurtec ODT, and Qulipta.
Monoclonal Antibody CGRP Antagonists
The long-acting, large molecule, monoclonal antibody CGRP antagonists work by blocking the activity of the calcitonin gene-related peptide, a neuropeptide that has been implicated in the pain and vasodilation processes associated with migraine attacks.
- Aimovig is a fully humanized monoclonal antibody that works by binding to the calcitonin gene-related peptide receptor.
- Ajovy, Emgality, and Vyepti are humanized monoclonal antibodies that target the calcitonin gene-related peptide ligand.
- Aimovig, Ajovy, and Emgality are all intended for self-injection using a single-dose prefilled syringe or autoinjector. Vyepti is administered via intravenous infusion.
Gepant CGRP Antagonists
The gepants are small molecule CGRP antagonists that can be administered orally. They work by blocking the CGRP receptor.
- Nurtec ODT is a dual therapy used for both acute and preventive treatment of migraine. It is taken as needed for the acute treatment of migraine, and every other day for the preventive treatment of episodic migraine.
- Qulipta is taken once daily for the preventive treatment of episodic migraine.
The following drugs are FDA approved for the preventive treatment of migraine in adults.
Emgality is also approved for the treatment of episodic cluster headache in adults.
| Drug Name | FDA Approval | Company | Drug Class | Dosage Form | Administration |
|---|---|---|---|---|---|
|
Qulipta (atogepant) |
September 28, 2021 | AbbVie Inc. | calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) | tablets |
once daily |
| Nurtec ODT (rimegepant) | also approved for treatment | Biohaven | calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) | orally disintegrating tablets |
every other day |
| Vyepti (eptinezumab-jjmr) | February 21, 2020 | Lundbeck Inc. | calcitonin-gene related peptide antagonist | intravenous infusion |
once every three months |
| Emgality (galcanezumab-gnlm) | September 27, 2018 | Eli Lilly and Company | calcitonin-gene related peptide antagonist | subcutaneous injection |
once monthly |
| Ajovy (fremanezumab-vfrm) | September 14, 2018 | Teva Pharmaceutical Industries Ltd. | calcitonin gene-related peptide antagonist | subcutaneous injection | once monthly OR once every three months |
| Aimovig (erenumab-aooe) | May 17, 2018 | Amgen Inc. | calcitonin gene-related peptide antagonist | subcutaneous injection | once monthly |
For more information, see Treatment & Prevention Tips for Living with Migraine Headaches
For a complete list of migraine treatments, see Medications for Migraine
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