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What are the new drugs for the treatment and prevention of migraine?

Medically reviewed by Judith Stewart, BPharm Last updated on Apr 6, 2020.

Official Answer

by Drugs.com
  • The newest drug (approved February 27, 2020) for the treatment of migraine is Nurtec ODT (rimegepant).
  • The newest drug (approved February 21, 2020) for the prevention of migraine is Vyepti (eptinezumab-jjmr).

New Drugs for the Treatment of Migraine

  • The newest drugs for the acute treatment of migraine are Nurtec ODT (rimegepant) and Ubrelvy (ubrogepant), both orally-administered calcitonin gene-related peptide (CGRP) receptor antagonists (gepants).
  • Another recently approved drug for the acute treatment of migraine is Reyvow (lasmiditan), the first serotonin (5-HT)1F receptor agonist.
  • The other new drugs for the acute treatment of migraine are novel formulations of sumatriptan, belonging to the class of drugs called serotonin (5-HT) receptor agonists (triptans). Sumatriptan is a well-established migraine treatment first approved in subcutaneous injection form under the brand name Imitrex in 1992. Sumatriptan is available in a variety of dosage forms, including injection, oral tablets, nasal spray, and nasal powder. Some formulations are also available as generics.

The following drugs are FDA approved for the acute treatment of migraine with or without aura in adults.

Drug Name FDA Approval Company Drug Class Dosage Form Administration
Nurtec ODT (rimegepant) February 27, 2020 Biohaven calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) orally disintegrating tablets

as needed; no more than one dose (75 mg) to be taken in 24 hours
(the safety of treating more than 15 migraines in a 30-day period has not been established)

Ubrelvy
(ubrogepant)
December 23, 2019 Allergan plc calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) oral tablets

as needed (a second dose may be administered at least 2 hours after the initial dose); no more than 200 mg to be taken in 24 hours

Reyvow (lasmiditan) October 11, 2019 Eli Lilly and Company serotonin (5-HT)1F receptor agonist (ditan) oral tablets

as needed; no more than one dose to be taken in 24 hours

Tosymra (sumatriptan) January 25, 2019 Dr. Reddy’s Laboratories Limited serotonin (5-HT)1B/1D receptor agonist (triptan) nasal spray

as needed; no more than 30 mg to be taken in 24 hours (doses separated by at least one hour)

Zembrace SymTouch (sumatriptan) January 28, 2016 Dr. Reddy’s Laboratories Ltd. serotonin (5-HT)1B/1D receptor agonist (triptan) subcutaneous injection

as needed; no more than 12 mg to be taken in 24 hours (doses separated by at least one hour)

Onzetra Xsail (sumatriptan) January 27, 2016 Avanir Pharmaceuticals, Inc. serotonin (5-HT)1B/1D receptor agonist (triptan) nasal powder

as needed; no more than two doses (44 mg) to be taken in 24 hours (doses separated by at least two hours)

New Drugs for the Prevention of Migraine

The newest drugs for the prevention of migraine belong to the class of drugs called calcitonin gene-related peptide (CGRP) antagonists and include Aimovig, AjovyEmgality, and Vyepti.

The FDA approved CGRP antagonists are long-acting monoclonal antibodies that work by blocking the activity of the calcitonin gene-related peptide, a neuropeptide that has been implicated in the pain and vasodilation processes associated with migraine attacks. Aimovig is a fully humanized monoclonal antibody that works by binding to the calcitonin gene-related peptide receptor. Ajovy, Emgality, and Vyepti are humanized monoclonal antibodies that target the calcitonin gene-related peptide ligand. Aimovig, Ajovy, and Emgality are all intended for self-injection using a single-dose prefilled syringe or autoinjector. Vyepti is administered via intravenous infusion.

The following drugs are FDA approved for the preventive treatment of migraine in adults.

Emgality is also approved for the treatment of episodic cluster headache in adults.

Drug Name FDA Approval Company Drug Class Dosage Form Administration
Vyepti (eptinezumab-jjmr) February 21, 2020 Lundbeck Inc. calcitonin-gene related peptide antagonist intravenous infusion

once every three months

Emgality (galcanezumab-gnlm) September 27, 2018 Eli Lilly and Company calcitonin-gene related peptide antagonist subcutaneous injection

once monthly

Ajovy (fremanezumab-vfrm) September 14, 2018 Teva Pharmaceutical Industries Ltd. calcitonin gene-related peptide antagonist subcutaneous injection once monthly OR once every three months
Aimovig (erenumab-aooe) May 17, 2018 Amgen Inc. calcitonin gene-related peptide antagonist subcutaneous injection once monthly

New Drugs in Clinical Development

Another CGRP antagonist in the clinical development pipeline is the 'gepant' atogepant (Allergan).

The 'gepants' are small molecule CGRP receptor antagonists intended for oral administration. Atogepant has a high potency and a long half-life, making it suitable for preventive treatment of migraine.

For more information, see Treatment & Prevention Tips for Living with Migraine Headaches

For a complete list of migraine treatments, see Medications for Migraine

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