Chapter 5, Episode 3: Gepants for the Treatment of Migraine Disease

This content has been medically reviewed by Vera Gibb, DNP, APRN, FNP-C, AQH

Gepants are a class of medications designed specifically to treat migraine. They are small molecules that target a protein called calcitonin gene-related peptide, or CGRP.¹

CGRP plays a big role in the migraine attack process because it transmits pain signals, causes inflammation, and dilates blood vessels. Gepants block CGRP from binding to its receptors to reduce migraine pain.¹

The four gepants approved for the acute and/or preventive treatment of migraine are oral tablets ubrogepant and atogepant, orally disintegrating tablet rimegepant, and nasal spray zavegepant.

Gepants are not the only migraine treatment to target CGRP. Anti-CGRP monoclonal antibodies also prevent CGRP from binding to its receptors. They are longer-acting medications administered intravenously or by injection.

Gepants are typically well tolerated. Side effects are relatively uncommon but may include decreased appetite, nausea, dizziness, constipation, sleepiness or allergic reaction.

Gepants may not be safe for people who take medications that affect the CYP3A4 liver enzyme, or for people with chronic liver or kidney conditions.

A few benefits of gepants are:

  • They do not cause medication overuse headache unlike some other acute migraine medications
  • They may be used for people with cardiovascular disease because they do not cause constriction of blood vessels
  • They can be used in combination with other acute and preventive treatments

With minimal side effects, no risk of medication overuse headache, and the ability to treat and/or prevent migraine attacks, gepants may be a promising option for many people living with migraine.

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This video is sponsored in part by Pfizer and AbbVie.



*The contents of this video are intended for general informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. AMD does not recommend or endorse any treatment, products, or procedures mentioned. Reliance on any information provided by this content is solely at your own risk.