Oral CGRP abortive (Nurtec) approved as migraine preventative in the US

Hi all,

I’m not sure how many of you use Nurtec as an abortive but I was just brought up to speed that it is now approved for use as a preventative in the US (= you can get more than 8 pills a month if approved by provider).

I hope this helps some people out there. :pray:

I don’t know if this link will post for the article (not sure if I have posting privileges).


This is great news!

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That shows you do have. Girl Done Good. Thanks for posting that. The more relevant material brought to the table the better. The community thrives on up-to-date information.


Yep all Trust Level 2 members are permitted to post links.

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Thank you for posting that!!

My pharmacy has only been able to get the 8 pills so I my clinic thoughtfully has been helping me with trial packs to get me through.

I’m in for an office visit at my clinic tomorrow and will ask about this as a preventative to add to my Topiramate XR and Emgality. I thought I was previously told not to take too much Nurtec because of rebounds, but I may have that confused with only one pill per 24 hours.

I’m printing out the article and taking it to my appointment tomorrow. Many thanks!! :heart:

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You’re so welcome, seems like they are updating their guidelines on Nurtec usage. Hopefully that means there has been some good results with patient outcomes. :pray:

I think you’ll likely have to choose between Nurtec as a preventative and Emgality since they are both CGRP drugs - and expensive.

I like Ubrelvy a lot and will take it as a preventative if it’s approved for that type of use. None too sure Cigna will agree to pay for that and Botox simultaneously given the high cost of both.

I just returned from my migraine clinic and I’m officially on Nurtec as a preventative!

You were correct, Emily, it’s either Emgality or Nurtec. Since Nurtec works for my VMs (it does nothing for my regular migraines - I use Imitrex nasal spray 20mg for them in addition to the other meds), I chose it over Emgality.

The Nurtec preventative dosing is one pill every other day. My clinic works with a specialty pharmacy to hopefully expedite the insurance debacle. They gave me a bunch of samples to hold me over.

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Good job! Best of Luck! Please let us know how it all goes. I’m sure a lot of us are paying attention. I am. Not having 32 shots of poison in my head every 10 weeks has a certain attraction.

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That’s some excellent news!

Glad to hear this worked out for you! :blush:

Nurtec arrived via UPS today. Fast service - very pleased!


Question for everyone who has knowledge about Nurtec:

I was given Nurtec samples to use as an abortive and I did not think it was much help. Then the Doctor told me to take Nurtec every other day as a “preventative”. I cannot seem to find much literature on it as it is so new a drug, but I would like to know if Nurtec is supposed to help with the “dizziness” that we experience instead of a “headache”?

I am taking it every other day as a preventative along with my two other meds (Amitriptyline and Propranolol). I get dizziness after I drive when I come to a stop. This seems to continue. Is Nurtec supposed to help with the dizziness or the sick head feeling? It has been difficult to find any information on its side effects and I do feel concerned about the long term effects of all these drugs.
Last weekend I suddenly got a call from my insurance that Nurtec is non-formulary and they won’t cover it. But the strange thing is that the day before I already received a shipment from the pharmacy my new neurologist sent the prescription to (Aspn or something of the like). I am just wondering how this happened. I am still trying to understand how it works.

Hi there,

I haven’t taken Nurtec as a preventative just yet. My understanding is that preventatives aren’t great at targeting specific symptoms (like dizziness) in long term treatment.

There are certainly some preventatives that seem to work better for our cohort. My understanding (from the docs I’ve seen) is that the preventatives are supposed to raise your migraine threshold and the symptoms that come along with your migraines. So if you get headaches, the meds should increase the threshold at which those headaches appear. If dizziness is your symptom, then the preventatives should increase the threshold for dizziness to appear.

I’m not a doc and there are others on here who have far more experience than I do with this illness and are more knowledgeable when discussing preventatives.

I think the hope with Nurtec and other CGRP inhibitors is that they will increase your overall migraine threshold over time.

@turnitaround and @Onandon03 please let me know if I have this wrong.



That’s the theory. Couldn’t have put it better myself Liz. The same preventatives are used whether one is a headacher or a dizzier person if one has a MAV diagnosis.


I’m on Nurtec as a preventative through ASPN pharmacy.

All the stuff I’m about to share came directly from my healthcare professional at the migraine clinic.

They explained to me that Nurtec typically takes 3-4 months to build up and be effective at raising the threshold so I should have fewer migraines/VMs or they may be less severe or the episode duration may be shorter. Basically, echoing comments above.

I asked the question about classic migraine vs. VM, since I get both, sometimes separately, sometimes together. They said that the various migraine meds (abortive or preventative) work differently for different individuals and the only way to figure out what works for me is trial and error.

When I had a particularly bad episode that included excessive dizziness, my clinic prescribed Meclizine (it’s OTC, but cheaper as Rx when covered). The Meclizine worked well for me for the excessive dizziness flare ups, but everyone is different.

They also explained ASPN as a specialty pharmacy that works with the drug manufacturer and provides discounted (or free) Nurtec while working with my insurance to get it covered. I think my insurance denied it twice, then finally approved coverage.

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So basically exactly the same as the oral preventatives even down to timescale. I recall reading when they first came out that their results were a predicted 50% reduction exactly the same too. Despite all the added hype I can’t see them stealing the heart of the NHS far too expensive when similar results can be achieved with older dirt cheap generic oral medication.

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For those of you using Nurtec as a headache abortive medication: after you take a lozenge, how long does it take before you notice a reduction (or elimination) of your headache?

I got some Nurtec from my doc and have tried it a couple of times. I don’t get headaches that often but when I do, they last for days. The first time it didn’t seem to do anything (but I took it after I’d had the headache for several days). The second time I took it when I felt like the headache was just starting, took a nap, and was fine when I woke up.

I had asked the pharmacist how long it usually takes to work but he had no idea. What is your experience?

I took Nurtec for the first time this week. My migraines are of the MAV variety and there isn’t any pain, just dizziness, vertigo and nausea. The Nurtec dissolved in about a minute and in about 20 minutes I could tell something was happening. Two hours later I was almost completely symptom free.

As for taking as a preventive medication, I could never afford that. I doubt I can afford it once the samples are gone.