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calcitonin gene-related peptide receptor agonists for migraine

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  • calcitonin gene-related peptide receptor agonists for migraine

    I have an inquiry from a mom who is working with a neurologist on migraine treatment. She has moved through many other treatments and is aware of the InfantRisk articles on migraine treatment in general.

    Her neurologist has said they would like to consider Nurtec (rimegapant) or Ubrelvy (ubrogepant). These are calcitonin gene-related peptide receptor agonists. By reading their prescribing information, I was able to find this info:

    Nurtec (rimegapant)
    molecular weight: 534.56
    plasma protein binding: 96%
    absolute oral bioavailability 64%
    half-life: 11 hours

    Ubrelvy (ubrogepant)
    molecular weight 549.6
    peaks at 1.5 hours
    plasma protein binding 87%
    half-life: 5-7 hours.

    The biggest difference I am seeing here is the half-life.

    Are you able to infer anything else about likely transfer to milk based on the limited data available with this newer class of drugs?

    Thank you!


  • #2
    halpina:

    I just finished a trial with Rimegapant in breastfeeding mothers. While I can't report any outcome, I can tell you that the levels in milk were exceedingly low.

    Good news.

    Tom Hale Ph.D.

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