Generic Name

Ubrogepant

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Classification

FDA Approved Indications

• Acute treatment of migraine with or without aura in adults

Mechanism of Action

Ubrogepant selectively antagonizes CGRP receptors, inhibiting the vasodilation and neurogenic inflammation associated with migraine pathophysiology, thereby relieving migraine pain.

Dosage and Administration

Adult: 50 mg orally as needed, may be repeated once after 2 hours, maximum dose of 100 mg in 24 hours.

Pediatric: Not established; safety and efficacy not determined.

Geriatric: No specific dosage adjustment recommended, but caution advised due to potential comorbidities.

Renal Impairment: Adjust dose if severe renal impairment (eGFR <30 mL/min); consult prescribing info.

Hepatic Impairment: No specific adjustment for mild to moderate impairment; use caution in severe impairment.

Pharmacokinetics

Absorption: Rapid absorption with peak plasma concentrations in approximately 1.5 hours.

Distribution: Protein binding approximately 87%.

Metabolism: Metabolized primarily by CYP3A4 with minor contribution from CYP2C9.

Excretion: Excreted mainly via feces (around 65%) and urine (around 23%).

Half Life: About 7 hours.

Contraindications

• Hypersensitivity to ubrogepant or excipients.

Precautions

• Use with caution in patients with hepatic impairment; monitor for hepatic adverse effects. There's limited data on safety in pregnancy and lactation. Consult the latest guidelines.

Adverse Reactions - Common

• Nausea (Less than 5%)
• Somnolence (Less than 5%)

Adverse Reactions - Serious

• Allergic reactions including angioedema, hypersensitivity (Rare)
• Hepatotoxicity (Rare, monitor liver function tests)

Drug-Drug Interactions

• CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) may increase ubrogepant levels; dose adjustment recommended.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication at the onset of migraine symptoms.
• Do not exceed max daily dose.
• Report unusual symptoms, especially signs of allergic reactions or liver problems.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: N/A

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Dizziness, somnolence, nausea, abdominal pain.

Treatment: Supportive care, activated charcoal if ingestion was recent, and symptomatic management.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable at controlled room temperature for up to 24 months.