Medically reviewed by Drugs.com. Last updated on Feb 21, 2023.
Applies to the following strengths: 50 mg; 100 mg
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Migraine
Initial dose: 50 to 100 mg orally, once
- After 2 hours, a second dose may be taken if needed
- The safety of treating more than 8 migraines in a 30-day period is unknown.
Use: For the acute treatment of migraine with or without aura.
Renal Dose Adjustments
Mild or moderate renal impairment: No adjustment recommended
Severe renal impairment (CrCl 15 to 29 mL/min): Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed; Maximum dose: 100 mg in 24-hours
ESRD (CrCl less than 15 mL/min): Avoid use
Liver Dose Adjustments
Mild or Moderate Hepatic Impairment (Child-Pugh A or B): No adjustment recommended
Severe Hepatic Impairment (Child-Pugh C): Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed; Maximum dose: 100 mg in 24-hours
Elderly: Dose selection should be cautious, consider starting at the low end of the dosing range
Concomitant Use with CYP450 3A4 Inhibitors:
- With Strong CYP450 3A4 Inhibitors: Contraindicated
- With Moderate CYP450 3A4 Inhibitors: 50 mg orally once in 24 hours
- With Weak CYP450 3A4 Inhibitors: Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed; Maximum dose: 100 mg in 24-hours
Concomitant Use with CYP450 3A4 Inducers:
- With Strong CYP450 3A4 Inducers: Avoid concomitant use
- With Weak and Moderate CYP450 3A4 Inducers: Initial dose: 100 mg orally once; a second dose of 100 mg may be taken 2 hours after initial dose
Concomitant Use with BCRP and/or P-gp Only Inhibitors: Initial dose: 50 mg orally once; a second 50 mg dose may be taken after 2 hours, if needed
- Concomitant use of strong CYP450 3A4 inhibitors
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available
- Take orally with or without food
- This drug is the first oral calcitonin gene-related peptide receptor antagonists approved for the acute treatment of migraine.
- Patients should be instructed to read the US FDA-approved patient labeling (Patient Information).
- Patients should understand that this drug interacts with a number of other drugs and it is important to report all other medications being used, including over the counter and herbal products; dose modifications may be necessary.
- Patients should be instructed to avoid grapefruit juice during therapy.
- Patients who are pregnant or planning to become pregnant should discuss this with their healthcare provider.
- Patients who are breastfeeding or planning to breastfeed should discuss this with their healthcare provider.
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