Ubrogepant
UBRELVY
Pronunciation: yoo-BROE-je-pant
“Yer bro’s Uber pants”
What it isCGRP-receptor antagonist; acute migraine treatment.
Why this oneUnlike rimegepant, it is designed only for acute use rather than prevention and causes no coronary vasoconstriction.
What limits itStrong CYP3A4 inhibitors must be avoided; nausea, cost, and prior authorization are the usual barriers.
FDA-approved for
- acute migraine (2019)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acute treatment of migraine (with or without aura) | Adults | 50 mg or 100 mg PRN | 50 mg or 100 mg PRN | 200 mg/24h |
Renal No adjustment for mild–moderate. Severe (CLcr 15–29): 50 mg initial, 50 mg second if needed. ESRD (<15): avoid
Hepatic No adjustment for mild–moderate. Severe (Child-Pugh C): 50 mg initial, 50 mg second if needed
Second dose, if needed, at least 2 hours after the initial dose; max 200 mg in 24 hours
Instructions
- Take orally with or without food
- If needed, a second dose may be taken ≥2 h after the initial dose
- Maximum 200 mg in 24 hours
- Safety of treating >8 migraines per 30 days not established
Available strengths
- tab 50, 100 mg
Contraindications
- Concomitant use of strong CYP3A4 inhibitors
Cautions
- Hypersensitivity reactions (anaphylaxis, dyspnea, facial/throat edema) — can occur minutes to days after dosing
- Hypertension — new-onset or worsening
- Raynaud's phenomenon — new-onset or worsening
Adverse reactions
- Nausea
- Somnolence
- Dry mouth
Pregnancy No adequate human data; animal embryofetal harm at high maternally-toxic doses; pregnancy registry available
Lactation Excreted in breast milk in low amounts (relative infant dose ~0.15%); weigh benefits/risks
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 50 mg | tab | per unit | — | $108.89/ea | not offered |
| 100 mg | tab | per unit | — | $109.11/ea | not offered |
Generic entry2039 est.
NO BOXED WARNINGS
Principal riskLittle; CYP3A4-dependent
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityAgent-specific vascular, serotonergic or hepatic risks; acute overdose is usually limited outside ergot or cardiovascular agents.
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