Qulipta: Use for migraine, cost, how it works, and more

Key takeaways

• Qulipta tablets are taken once per day to help prevent migraine symptoms. It may take a few weeks to feel the drug’s full effects.
• If you have a migraine episode while taking Qulipta, your doctor may recommend taking another drug (such as a triptan or an over-the-counter option) to treat it.
• Qulipta works by blocking calcitonin gene-related peptide (CGRP) receptors in the nervous system. CGRP is a protein that’s been shown to cause migraine symptoms.

Qulipta (atogepant) is approved by the Food and Drug Administration (FDA) to help prevent migraine episodes in adults who have episodic migraine or chronic migraine.

Drug details

You’ll find key information about Qulipta here.

• Drug class: calcitonin gene-related peptide (CGRP) antagonist
• Drug form: oral tablet
• Generic available? no
• Prescription required? yes
• Controlled substance? no
• Year of FDA approval: 2021

Qulipta is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics usually cost less than brand-name drugs.

The Food and Drug Administration (FDA) approves prescription drugs such as Qulipta to treat certain conditions.

Qulipta is FDA approved to help prevent migraine episodes in adults who have episodic migraine or chronic migraine.

Migraine explained

Migraine is a condition affecting the brain and nerves. When you have migraine, you experience repeated migraine episodes (also called migraine attacks).

Symptoms of a migraine episode typically include:

• moderate or severe throbbing headache that gets worse with movement
• nausea and vomiting
• increased sensitivity to light and sound

You may also experience sensory symptoms called an aura before or during the headache. These may include:

• seeing flashing or sparkling lights or zigzag lines
• having blank spots or patches in your vision
• feeling “pins and needles” sensations
• having trouble concentrating or speaking

A migraine episode can last between 4 and 72 hours. It can affect your ability to carry on with daily activities. Some people may also feel very tired or fatigued for a few days after the episode.

Depending on how often you have migraine episodes, your doctor may determine that you have episodic or chronic migraine. With episodic migraine, you have migraine episodes that affect you for up to 14 days each month. With chronic migraine, you have migraine episodes that affect you 15 or more days each month.

Qulipta is approved for both types of migraine. You take the drug every day to help reduce the number of migraine episodes you have each month.

To learn more about migraine and its treatment, visit our headache and migraine hub.

Effectiveness for migraine prevention

Qulipta has been found effective in helping prevent migraine episodes in people with either episodic migraine or chronic migraine. To find out how the drug performed in clinical trials, see Qulipta’s prescribing information.

Qulipta and children

At this time, Qulipta is not FDA approved for use in children. The drug has not been studied in this age group.

As with all medications, the price of Qulipta can vary. The actual price you’ll pay depends on your insurance plan, if you have one, your location, and the pharmacy you use.

Financial and insurance assistance: If you need financial support to pay for Qulipta, or if you need help understanding your insurance coverage, help is available.

A program called Qulipta Complete is available, which provides a savings card and access to cost support staff. For more information and to find out whether you’re eligible for support, call 855-QULIPTA (855-785-4782). You can also visit the manufacturer’s website.

Generic version: Qulipta is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Qulipta is approved to help prevent migraine episodes in adults who have episodic migraine or chronic migraine.

What happens with migraine

Migraine episodes happen when certain changes occur in and around your brain. A protein called calcitonin gene-related peptide (CGRP) plays a key role in causing these changes.

Levels of CGRP increase during a migraine episode. CGRP attaches to special sites called CGRP receptors found in various places in your brain and nerves. When CGRP attaches to these receptors, it causes:

• Inflammation (swelling) and vasodilation (widening) of blood vessels in and around your brain. This is a cause of migraine headache.
• Increased pain signaling in your brain. This worsens the migraine headache and can also increase sensitivity to light and sound.

What Qulipta does

Qulipta is a type of drug called an oral CGRP antagonist. The way Qulipta works (its mechanism of action) is by preventing CGRP from attaching to its receptors. By blocking the action of CGRP receptors, Qulipta stops CGRP from causing the symptoms of a migraine episode. This helps reduce the number of migraine episodes that you have.

How long does it take for Qulipta to work?

Qulipta starts to work soon after you start taking it. However, it may take a few weeks before you notice fewer migraine episodes. Qulipta can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Qulipta. These lists do not include all possible side effects. For more information about the possible side effects of Qulipta, you can talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may concern or bother you. Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Qulipta and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here is a partial list of mild side effects of Qulipta. To learn about other mild side effects, talk with your doctor or pharmacist, or view Qulipta’s prescribing information.

Mild side effects of Qulipta can include:

• reduced appetite
• weight loss
• elevated liver enzymes, which may be a sign of liver damage
• nausea
• dizziness
• constipation (see “Side effect details”)
• fatigue and tiredness (see “Side effect details”)
• mild allergic reaction

Most of these side effects may go away within a few days or a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Qulipta weren’t reported in clinical trials of the drug, but it’s possible they may still occur. And some side effects have been reported since Qulipta became available for use, after clinical trials finished.

Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects can include:

• high blood pressure
• Raynaud phenomenon (lack of circulation in the fingers or toes)
• serious allergic reaction (see “Side effect details”)

Side effect details

Here are some details on certain side effects this drug may cause.

Constipation

Constipation may occur while taking Qulipta. In clinical trials, constipation was among the more common side effects reported with the drug. It was slightly more common in people who took higher doses of the medication.

What you can do

You may be able to ease constipation due to Qulipta with simple lifestyle changes. These include getting enough gentle exercise, drinking plenty of fluids, and increasing the amount of fiber in your diet.

If you have constipation that’s severe or does not go away, talk with your doctor or pharmacist. They may recommend taking a laxative medication. They may also recommend taking a lower dose of Qulipta.

Fatigue and tiredness

Fatigue, tiredness, or sleepiness may occur while taking Qulipta. These were among the more common side effects reported with Qulipta in clinical trials. They were slightly more common in people who took higher doses of the medication.

Keep in mind that you may also have fatigue and tiredness before, during, and after a migraine episode. It’s still possible to have migraine episodes while taking Qulipta. (To learn more about other drugs that may be used with Qulipta, see the “Qulipta use with other drugs” section.)

What you can do

If you have fatigue, tiredness, or sleepiness while taking Qulipta, you should not drive or do other potentially dangerous activities, such as using machinery.

These side effects may ease as your body gets used to the medication. However, if you have fatigue or tiredness that’s severe or bothering you, talk with your doctor or pharmacist. They may recommend some ways to help manage fatigue, such as taking Qulipta at bedtime or trying a lower dose of Qulipta. Or they may recommend switching to a different medication to help prevent migraine.

Allergic reaction For some people, Qulipta can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious. Ways to manage For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication. For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Qulipta, your doctor may recommend a different medication instead.

The Qulipta dosage your doctor prescribes will depend on several factors. These include:

• the type of migraine you have
• the frequency and severity of your migraine episodes
• your kidney function
• other medications you take

Typically, your doctor will start you on a low dosage. Then, they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Qulipta comes as a tablet that you take by mouth. It’s available in three strengths:

• 10 milligrams (mg)
• 30 mg
• 60 mg

Dosage for migraine prevention

The recommended dosage of Qulipta to help prevent migraine attacks due to episodic migraine is 10 mg, 30 mg, or 60 mg, taken once every day. Your doctor will determine the dosage that’s right for you.

For helping prevent migraine attacks due to chronic migraine, the recommended dosage of Qulipta is 60 mg, taken once every day.

What if I miss a dose?

If you miss a dose of Qulipta, take it as soon as possible. However, if it’s nearly time for your next dose, skip the missed dose and take your next scheduled dose as usual. You should not take extra doses to make up for a missed dose.

Will I need to use this drug long term?

Qulipta is meant to be used as a long-term treatment. If you and your doctor determine that Qulipta is safe and effective for you, you’ll likely take it long term. Here are answers to some frequently asked questions about Qulipta.

Does Qulipta cause weight loss?

It’s possible that you might lose weight while taking Qulipta. The medication can cause a decreased appetite in some people. Over time, this could lead to weight loss. However, it’s important to note that Qulipta is not FDA approved for weight loss. If you’re concerned about weight loss while taking Qulipta, talk with your doctor. They can recommend ways to maintain a weight that’s healthy for you.

Does Qulipta treat migraine headaches while they’re happening?

No. Qulipta is approved to help prevent migraine episodes. The drug hasn’t been studied for treating migraine headaches while they’re happening. It is unknown whether Qulipta is effective for this use. Talk with your doctor about how to treat migraine headaches that may still occur while you’re taking Qulipta. For examples of medications that your doctor may recommend, see the “Qulipta use with other drugs” section.

Can older people take Qulipta?

Older people can likely take Qulipta. The drug is not expected to cause any specific problems in older people. However, clinical trials did not include enough people ages 65 years and older. So it is unknown whether older people respond to Qulipta differently from younger people. Older people are more likely to have decreased kidney function, which can affect dosing. If you’re age 65 years or older, your doctor will likely prescribe a low dose of Qulipta to start. If this does not cause any bothersome side effects, they may increase your dose if needed. Your doctor can answer any questions you have about taking Qulipta. Qulipta is not known to interact with alcohol. However, if you have certain side effects with Qulipta, these could be made worse by drinking alcohol. Examples of these side effects include fatigue, tiredness, and nausea. It’s important to note that drinking alcohol can trigger migraine episodes in some people. Qulipta helps prevent migraine episodes. If you drink alcohol and know that it’s one of your migraine episode triggers, you should avoid drinking it during treatment with Qulipta. If you’re not sure what triggers your migraine episodes, talk with your doctor about keeping a migraine diary. This can help you work out potential triggers to avoid. You’ll typically take Qulipta by itself to help prevent migraine episodes. However, you may still experience migraine episodes while taking this medication. If you have a migraine episode while taking Qulipta, your doctor may recommend taking certain other drugs to treat your symptoms. These drugs may include:

• over-the-counter pain relievers such as: acetaminophen (Tylenol) acetaminophen/aspirin/caffeine (Excedrin Migraine) aspirin ibuprofen (Advil, Motrin) naproxen (Aleve)
• acetaminophen (Tylenol)
• acetaminophen/aspirin/caffeine (Excedrin Migraine)
• aspirin
• ibuprofen (Advil, Motrin)
• naproxen (Aleve)
• prescription pain relievers such as: acetaminophen/caffeine/dihydrocodeine (Trezix) acetaminophen/codeine (Tylenol with codeine) diclofenac ketorolac tramadol
• acetaminophen/caffeine/dihydrocodeine (Trezix)
• acetaminophen/codeine (Tylenol with codeine)
• diclofenac
• ketorolac
• tramadol
• triptans such as: almotriptan eletriptan (Relpax) frovatriptan (Frova) naratriptan (Amerge) rizatriptan (Maxalt, Maxalt MLT) sumatriptan (Imitrex, Tosymra, Onzetra Xsail, Zembrace Symtouch) zolmitriptan (Zomig)
• almotriptan
• eletriptan (Relpax)
• frovatriptan (Frova)
• naratriptan (Amerge)
• rizatriptan (Maxalt, Maxalt MLT)
• sumatriptan (Imitrex, Tosymra, Onzetra Xsail, Zembrace Symtouch)
• zolmitriptan (Zomig)
• ergot medications such as: dihydroergotamine (Migranal) ergotamine tartrate (Ergomar) ergotamine/caffeine
• dihydroergotamine (Migranal)
• ergotamine tartrate (Ergomar)
• ergotamine/caffeine

Note: While you take Qulipta, your doctor usually won’t prescribe another migraine medication that’s in the same drug class as Qulipta. Qulipta belongs to the drug class calcitonin gene-related peptide (CGRP) antagonists. Examples of other CGRP antagonists include rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy).

Qulipta can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Qulipta and other medications

Below is a list of medications that can interact with Qulipta. This list does not contain all drugs that may interact with Qulipta.

Before taking Qulipta, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Types of drugs that can interact with Qulipta include:

• Drugs that are strong CYP3A4 inhibitors. Taking Qulipta with a strong CYP3A4* inhibitor can increase the risk of side effects from Qulipta. If you take Qulipta with one of these drugs, your doctor will likely prescribe a 10-milligram (mg) dose of Qulipta. Examples of these drugs include: clarithromycin itraconazole (Sporanox, Tolsura) ketoconazole
• clarithromycin
• itraconazole (Sporanox, Tolsura)
• ketoconazole
• Drugs that are strong or moderate CYP3A4 inducers. Taking Qulipta with a strong or moderate CYP3A4* inducer can make Qulipta less effective than usual. If you take Qulipta with one of these drugs, your doctor will likely prescribe a 30-mg or 60-mg dose of Qulipta. Examples of these drugs include: carbamazepine (Carbatrol, Equetro, Tegretol) efavirenz (Sustiva) etravirine (Intelence) phenytoin (Dilantin, Phenytek) rifampin (Rifadin)
• carbamazepine (Carbatrol, Equetro, Tegretol)
• efavirenz (Sustiva)
• etravirine (Intelence)
• phenytoin (Dilantin, Phenytek)
• rifampin (Rifadin)
• Drugs that are OATP inhibitors. Taking Qulipta with an OATP† inhibitor can increase the risk of side effects from Qulipta. If you take Qulipta with one of these drugs, your doctor will likely prescribe a 10-mg or 30-mg dose of Qulipta. An example of this type of drug is cyclosporine (Gengraf, Neoral, Sandimmune).

* CYP3A4 stands for cytochrome P450 3A4, which is a type of enzyme (a protein that helps with chemical changes in the body). † OATP stands for organic anion transporting polypeptide, which is a type of protein.

Qulipta and herbs and supplements

Taking Qulipta with the herbal supplement St. John’s wort can make Qulipta less effective than usual. If you take Qulipta with St. John’s wort, your doctor will likely prescribe a 30-mg or 60-mg dose of Qulipta.

No other herbs or supplements have been specifically reported to interact with Qulipta. However, you should still check with your doctor or pharmacist before using any of these products while taking Qulipta.

Qulipta and foods

Grapefruit and grapefruit products can block the breakdown of Qulipta. This may cause the drug to build up in your body, increasing the risk of side effects. As a result, your doctor will likely recommend that you avoid consuming grapefruit products while taking Qulipta.

If you have any questions about eating certain foods with Qulipta, talk with your doctor.

You should take Qulipta according to your doctor’s instructions.

When to take

Qulipta comes as an oral tablet that you will take once per day. You can take your dose at any time of day. However, try to be consistent with the time of day you choose.

Taking Qulipta with food

You can take Qulipta with or without food.

Can Qulipta be crushed, split, or chewed?

Qulipta is meant to be swallowed whole. The manufacturer does not indicate whether you can crush, split, or chew these tablets. If you have trouble swallowing Qulipta tablets whole, talk with your doctor or pharmacist. If you can become pregnant, consider the following information about pregnancy, birth control, and breastfeeding.

Qulipta and pregnancy

It’s not known whether Qulipta is safe to use while pregnant. Animal studies have shown harm to the fetus, but animal studies don’t always predict what may happen in humans. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

If you take Qulipta while pregnant, you could enroll in this pregnancy registry, which gathers information about how certain migraine drugs affect pregnancy. Your doctor can provide more information about this.

Qulipta and birth control

It’s not known whether Qulipta is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control options while you’re taking Qulipta.

Qulipta and breastfeeding

It’s not known whether Qulipta is safe to use while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Before taking Qulipta, talk with your doctor about your health history. Qulipta may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• history of allergic reaction to Qulipta or any of its ingredients
• high blood pressure
• Raynaud phenomenon
• kidney problems
• liver problems
• pregnancy or breastfeeding
• alcohol consumption

Note: For more information about the potential negative effects of Qulipta, see the “Qulipta side effects” section above.

Do not use more Qulipta than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Qulipta

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.