CGRP Treatment Options -Preventative and Acute

In 2018 the first migraine-specific preventative medications, CGRP monoclonal antibodies, entered the market. Before 2018 migraine sufferers were put on a wide variety of drugs including anti-depressants, Alzheimer’s medications, and anti-epileptic drugs. The ability of these drugs to reduce migraine attacks was an unintended side effect and had nothing to do with the original function of the medication. Although they did help a number of patients, these medications also came with a long list of side effects. Thankfully, there is a new wave of migraine treatment innovation. Here you can find a summary of all the CGRP treatment options on the market.

What is CGRP?

Calcitonin gene-related peptide (CGRP) is a protein that carries pain signals along nerves that are involved in generating the headache pain associated with migraine. Gepants work to block CGRP from attaching to its receptor and initiating those pain signals.

What CGRP medications can I choose from?

Preventative options:

There are four monoclonal antibody drugs that are monthly injections or one is a quarterly infusion:

  • Aimovig (erenumab-aooe)
  • Emgality (Galcanezumab)
  • Ajovy (Fremanezumab)
  • Vyepti (Eptinezumab-jjmr); *infusion

There are also two GEPANT drugs that are in pill or dissolvable tablet form that you take once daily or every other day:

  • Qulipta (Atogepant)
  • Nurtec ODT (Rimegepant) *every other day

Acute options:

These GEPANT and DITAN medications are in pill form and can be taken as needed. The best part about these is that evidence suggest that they do not run the risk of medication overuse headache (MOH), which you risk with triptans and NSAIDS (advil, Ibprofen, Excedrin, etc.)

  • Gepants:  
    • Ubrelvy (Ubrogepant), Nurtec ODT (Rimegepant)
  • Ditans:
    • Reyvow (Lastmiditan)

*Acute vs. preventative medications: Acute medications, also known as abortive medications, are the drugs that you take when you feel an attack coming on. The sooner you can take them the more effective they are at diminishing an attack. Preventative medications are prescribed for individuals with more than 15 migraine attacks per-month and work to stave off future attacks.


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