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What is this information about?
This information is about a medicine called rimegepant. The brand name of this medicine is Vydura.
Rimegepant is used to help prevent people with episodic migraine from having so many migraines each month. Your migraine is called ‘episodic migraine’ if you get four to seven migraines a month.
Rimegepant is also used as a ‘rescue medication’ for people with chronic migraine to stop the migraine from hurting so much. Your migraine is called ‘chronic migraine’ when you have more than eight migraines and fifteen headache days each month.
This information explains:
- how rimegepant works
- who can take it
- what the side effects are
- what benefit you may get from taking it
- what things mean you should not take it (what are rimegepant’s ‘cautions’).
Why have I been given this information?
You have been given this information because the Headache Service team have prescribed rimegepant for you. This is because the medicines that you have been given to treat your migraines so far have not worked well for you.
Rimegepant may help you to have less migraines and make those that you do have less severe.
The information in this leaflet will help you to know what to expect from your treatment and to be safe while you are taking it.
How does rimegepant work?
Rimegepant is one of a type of drugs called GEPANTs. These reduce the release of a substance called Calcitonin Gene Related Peptide (CGRP) into your body when you have a migraine.
Too much CGRP is thought to be released during a migraine attack and this is possibly why you feel pain when you are having a migraine.
Some medicines called triptans which are used to treat migraine make your blood vessels narrower so less blood can flow through them. Rimegepant does not do this.
Because of this it can be used in some people who have had a history of cardiovascular conditions, unless their consultant says that it should not be used.
Some people who take triptans for their migraines get ‘overuse headaches’. These are headaches caused by taking too many triptans and pain killers each month. Rimegepant does not cause the same problem.
Who can have rimegepant treatment?
Be aware
There are criteria which you must meet before we can prescribe rimegepant for you.
The National Institute for Clinical Excellence (NICE) recommends rimegepant for two situations:
- to prevent episodic migraine (4 -14 migraines a month).
The dose is usually one 75mg wafer every other day. Do not take more than one wafer a day.
Before you can have rimegepant, you must have tried at least three other prescription medicines that:
- have not worked or
- have had side effects that mean you cannot keep taking them
2. as a medicine that you take when you are getting a migraine
The dose is usually one 75mg wafer as and when you need it. Do not take more than one wafer a day.
Before you can have rimegepant as a rescue medication you must have tried at least two different triptan medicines which:
- have not worked or
- have had side effects that mean you cannot keep taking them or you are unable to take them
What side effects could I get from taking rimegepant?
Like most medicines rimegepant can have side effects. The most usual side effects include:
- tiredness (fatigue)
- a dry mouth
- feeling sick (nausea)
- rash
- sinus, throat, or airway infections.
Be aware
If you are concerned about possible side effects do speak to your clinician.
If you are finding it difficult to breath (you have shortness of breath), stop taking rimegepant straight away and speak to your clinician.
How well might rimegepant work for me?
- As a preventive to stop you from getting migraines it can mean you may have half as many monthly migraine days.
- As an acute treatment to treat the migraines that you do get:
- around six out of ten people will feel pain relief within two hours
- nearly nine out of ten people will not need to take any more pain killers in the next 24 hours.
Which health conditions that I may have had must I tell my consultant or the headache nursing team about?
You must not take rimegepant if you are pregnant or breastfeeding.
Some health conditions mean that taking rimegepant might not be safe for you.
Let your consultant or headache nursing team know if you have ever experienced or experience any of the following:
- high blood pressure (blood pressure over 150mmHg systolic)
- heart attack
- stroke
- DVT
- transient ischemic attack (TIA)
- unstable angina
- if you plan pregnancy in near future or if you are breastfeeding
- a disease or condition which has damaged your liver or kidneys, so they do not work as well
- have bowel disease that makes you more likely to be constipated.
Be aware
We do not have enough information to know fully how people over the age of 65 react to rimegepant.
You can take rimegepant alongside NSAID and triptan painkillers. These include medicines such as paracetamol, ibuprofen, naproxen and aspirin.
Gepants can interact with other medications – please speak to your clinician about this
Which members of the Specialist Headache Service Team might I meet?
The Specialist Headache Service team includes:
Lead consultant neurologist for headache: Jeban Ganesalingam
Senior Clinical Nurse Specialist: Claire Fisher
Clinical nurse specialists: Madara Freiberga and Charlotte Brown
Who should I contact if I have any questions or concerns about rimegepant treatment for migraine after I have read this information?
Email: uhsussex.headache.service.admin@nhs.net.
Our office is staffed from Monday to Friday.
The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.