Nurtec ODT (rimegepant) treats migraine in adults. It is the first FDA-approved medication that works as both an acute treatment to stop a migraine attack in progress and a preventive treatment to reduce how many migraine days you have each month. It comes as a 75 mg orally disintegrating tablet that dissolves on your tongue without water.
Two Approved Uses for Migraine
Nurtec has two distinct FDA-approved indications, both for adults with migraine (with or without aura):
- Acute treatment: A single 75 mg tablet taken when a migraine attack starts, to relieve pain and associated symptoms like nausea or light sensitivity.
- Preventive treatment: One 75 mg tablet taken every other day on an ongoing schedule, to reduce the number of migraine days you experience each month.
This dual role is unusual. Most migraine medications fall into one category or the other. Triptans, for example, only treat attacks as they happen. Monthly injections that target the same biological pathway only work as preventives. Nurtec can do both, though your doctor will determine which use (or both) makes sense for your situation.
Nurtec is not approved for children or adolescents. Its safety and effectiveness in pediatric patients have not been established.
How It Works
During a migraine, your body releases high levels of a protein called CGRP (calcitonin gene-related peptide). This protein binds to receptors on nerve cells and blood vessels in the brain, triggering the cascade of pain, inflammation, and sensory sensitivity that makes migraines so debilitating.
Nurtec belongs to a class of drugs called “gepants.” These molecules have an extremely high affinity for CGRP receptors, meaning they latch onto those receptors and block CGRP from activating them. When CGRP can’t reach its target, the pain signaling process is interrupted. For acute treatment, this stops an attack that’s already underway. For prevention, regular dosing keeps the pathway suppressed so attacks are less likely to start in the first place.
One important distinction from older migraine drugs like triptans: gepants do not constrict blood vessels. Triptans work partly by narrowing blood vessels in the brain, which makes them risky for people with heart disease, uncontrolled high blood pressure, or a history of stroke. Nurtec avoids that mechanism entirely, making it an option for some people who can’t safely take triptans.
How Well It Works for Acute Attacks
In a pivotal clinical trial, 21.2% of patients who took a single Nurtec tablet were completely pain-free at two hours, compared to placebo. That number may sound modest, but complete pain freedom is a strict benchmark. A larger percentage experienced meaningful pain relief (dropping from moderate or severe pain to mild or no pain) within that same window.
Beyond pain, the trial also measured relief from each patient’s “most bothersome symptom,” which could be nausea, sensitivity to light, or sensitivity to sound. Nurtec significantly outperformed placebo on that measure as well. Patients in the trial were also more likely to return to normal functioning at two hours and less likely to need a rescue medication within 24 hours. Pain freedom was sustained out to 48 hours in a significant proportion of patients, suggesting the effect lasts well beyond the initial dose.
How Well It Works for Prevention
For prevention, Nurtec was studied in people with episodic migraine, meaning they experienced between 4 and 14 migraine days per month. After about three months of taking 75 mg every other day, patients reduced their monthly migraine days by an average of 4.3 days, compared to a 3.5-day reduction with placebo. That difference of nearly one additional migraine-free day per month was statistically significant.
A one-day difference over placebo may not sound dramatic on its own, but placebo responses in migraine prevention trials tend to be large. The 4.3-day overall reduction is the more practical number. For someone who starts with 8 or 10 migraine days a month, cutting that roughly in half represents a meaningful change in quality of life. The full preventive effect takes time to build, with efficacy measured during weeks 9 through 12 of treatment, so it’s not an overnight fix.
What It Does Not Treat
Nurtec is specifically approved for migraine. It is not indicated for other types of headaches, such as tension-type headaches or cluster headaches, though some of these conditions are being explored in separate research. It also does not treat the underlying cause of migraine. It manages symptoms and frequency, meaning migraines can return if you stop taking it preventively.
What to Expect When Taking It
The tablet dissolves on your tongue, typically within seconds, and doesn’t require water. This is a practical advantage during a migraine, when nausea can make swallowing a pill difficult. For acute use, you take one tablet when a migraine starts and do not take another within 48 hours. For prevention, the schedule is one tablet every other day.
Nurtec is part of a newer class of migraine drugs, and gepants as a group tend to cause fewer side effects than triptans. In clinical trials, the most commonly reported side effect was nausea, though rates were relatively low. Hypersensitivity reactions, including rash and difficulty breathing, have been reported rarely. If you’ve ever had an allergic reaction to rimegepant, you should not take it again.