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Ubrelvy: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Feb 19, 2021.

1. How it works

  • Ubrelvy is a brand (trade) name for ubrogepant which is a medicine that may be used to treat migraines in adults.
  • Ubrelvy works by preventing the CGRP from attaching to CGRP receptors on nerve endings. CGRP is a protein that is thought to play a role in migraine attacks by causing pain, dilation of blood vessels, and inflammation. Research in the 1980s found that intravenous infusions of CGRP triggered typical migraine attacks in people susceptible to migraines. By preventing CGRP from binding to its receptor Ubrelvy stops migraine pain and other symptoms.
  • Ubrelvy belongs to the class of medicines known as calcitonin gene-related peptide (CGRP) receptor antagonists (gepants).

2. Upsides

  • May be used to treat acute migraines with or without aura in adults. Ubrelvy does not prevent migraines.
  • Taken orally (by mouth).
  • Available in 50mg and 100mg tablets.
  • One tablet (either 50mg or 100mg) is taken as soon as possible after the migraine starts then another dose may be taken at least 2 hours after the initial dose if necessary (no more than 200 mg to be taken in 24 hours).
  • Short-acting (the effects of Ubrelvy last just over a day).
  • Not a narcotic and does not cause addiction.
  • Well tolerated.
  • Helps to relieve pain that occurs with migraine headaches as well as migraine-related symptoms such as light sensitivity, sound sensitivity, or nausea. In some people, Ubrelvy completely stops the pain.
  • Does not prolong the QT interval.
  • May be taken with or without food.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Nausea and somnolence (sedation/drowsiness) are the most common side effects reported occurring in 4% and 3% respectively of people taking Ubrelvy 100mg. Dry mouth was reported in 2% of people.
  • Does not prevent migraine headaches.
  • Not approved for use in children.
  • If needed, a second dose may be taken but this must be at least 2 hours after the first dose. Advise patients that they should not take more than 200 mg in 24 hours. It is not known if it is safe to treat more than 8 migraines in 30 days.
  • Use the 50mg dosage for people already taking CYP3A4 inhibitors, BCRP and P-gp only inhibitors, and for severe renal and hepatic impairment. Use the 100mg dosage for people taking CYP3A4 inducers. Avoid Ubrelvy with strong CYP3A4 inducers and in end-stage renal disease.
  • There is not enough data to know the effect Ubrelvy has during pregnancy on the unborn child. There are no data on the effect of Ubrelvy during lactation.
  • No generic form of Ubrelvy is available.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Ubrelvy may be used to treat acute migraine attacks in adults and works by blocking the effects of a protein, called CGRP that is thought to play a role in migraine attacks by causing pain, dilation of blood vessels, and inflammation. Ubrelvy is well-tolerated and less than 5% of people report side effects such as nausea, somnolence, and dry mouth. Ubrelvy does not prevent migraines.

5. Tips

  • Ubrelvy is a tablet that is taken orally (by mouth) when you have a migraine, a second dose may be taken after at least 2 hours if required and you have not taken any interacting medicines or grapefruit products.
  • Ubrelvy is only taken when you have a migraine, it is NOT used to prevent migraines.
  • Ubrelvy is available as a 50 mg tablet and a 100mg tablet. Your prescriber will determine which dose is correct for you.
  • Swallow the tablet whole with a glass of water when you have a migraine. Ubrelvy can be taken with or without food.
  • If you have frequent migraines, talk to your doctor. It is not known if it is safe to use Ubrelvy to treat more than 8 migraines within 30 days.
  • Tell your doctor or other health care provider about all the medicines you take, including prescription and over-the-counter (OTC) medicines, vitamins, and herbal supplements. Let them know if you eat grapefruit or drink grapefruit juice. Ubrelvy interacts with several medicines and it may not be safe to take them together.
  • There is no data on the use of Ubrelvy during pregnancy. Tell your doctor immediately if you become pregnant.

6. Response and Effectiveness

  • Ubrelvy starts to work after approximately one and a half to two hours, with its maximum effect being between 3 to 8 hours.
  • Clinical trials showed that after 2 hours 21.2% of patients taking Ubrelvy 100mg were pain-free compared to 11.8% of patients taking placebo. Over the next 3 to 8 hours the percentage of patients that were pain free increased so that after 8 hours the over 70% of Ubrelvy 100mg patients were pain-free and over 50% of the placebo patients were also pain-free.
  • Clinical trials also measured pain relief after 2 hours. In the patients who took Ubrelvy 100mg 61.4% of patients had pain relief compared to 49.1% of patients that took the placebo. In addition, after 2 hours 37.7% of patients taking Ubrelvy 100mg had an absence of bothersome migraine symptoms (photophobia, phonophobia, or nausea) compared to 27.8% of patients who were taking the placebo.

7. Interactions

Medicines that interact with Ubrelvy may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Ubrelvy. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Ubrelvy include:

  • antibiotics, such as clarithromycin or ciprofloxacin
  • anticonvulsants, such as phenytoin
  • antifungals, such as itraconazole or ketoconazole
  • BCRP and/or P-gp only inhibitors such as quinidine, carvedilol, eltrombopag, or curcumin
  • bosentan
  • cancer treatments such as ceritinib
  • cyclosporine
  • HIV medications such as cobicistat, indinavir, and ritonavir
  • modafinil
  • rifampin
  • serotonin modulators, such as nefazodone and trazodone
  • some heart medications, such as diltiazem, or verapamil
  • St John's wort
  • any medication that inhibits (itraconazole, ketoconazole) or induces (rifampin, carbamazepine) CYP3A4.

A second dose of Ubrelvy should not be taken by people who have consumed grapefruit or grapefruit juice or take any of these medications: verapamil, cyclosporine ciprofloxacin, fluconazole, or fluvoxamine.

Alcohol may worsen the side effects of Ubrelvy such as drowsiness, dizziness, and liver toxicity.

Avoid eating grapefruit or drinking grapefruit juice during treatment with Ubrelvy because it may increase blood levels and increase the risk of side effects such as nausea and sedation.

Note that this list is not all-inclusive and includes only common medications that may interact with Ubrelvy. You should refer to the prescribing information for Ubrelvy for a complete list of interactions.

References

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Ubrelvy only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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