Does Nurtec ODT cause weight gain?

Weight gain with Nurtec ODT has not been reported as a side effect in studies looking at its use for either migraine treatment or prevention. In general, Nurtec ODT is well tolerated, with less than 3% of patients reporting a side effect during use.

Reported side effects with Nurtec ODT include possibly severe allergic reactions, which may include shortness of breath and severe rash (<1%), nausea (2% and 2.7%) and stomach-area pain or indigestion (2.4%).

Does Nurtec ODT for migraine treatment cause weight gain?

Weight gain was not seen in safety studies lasting up to one year in patients taking Nurtec ODT for treatment of migraine headache. These studies included over 1,700 adult patients receiving the 75 mg dose of Nurtec ODT intermittently for the treatment of acute migraine headache.

In these studies, the most common side effect was nausea in 2% of patients (2 out of every 100 patients), compared to <1% of patients who received a placebo (inactive) pill.

Does Nurtec ODT for migraine prevention cause weight gain?

Weight gain was not reported as a side effect in studies looking at the use of an oral dose of rimegepant (a different form than the Nurtec ODT) for the preventive treatment of migraine. In studies up to one year long, 603 patients received one 75 mg dose of rimegepant every other day.

In these studies for the prevention of migraine, the most common side effect was nausea (2.7%) compared to 0.8% of patients who received a placebo (inactive) pill. Stomach area pain and indigestion (dyspepsia) were also reported in 2.4% of participants who received rimegepant compared with 0.8% of patients who received a placebo pill.

If you are concerned about weight gain while taking a migraine treatment, speak with your healthcare provider. Obesity itself is linked with migraine and is thought to increase the risk of developing migraines. As obesity increases, so does the risk and severity of migraine headaches.

Life-style modification, which might include a plan of weight loss and increased exercise, may help to improve your migraine headache. Always contact your healthcare provider for any medication side effects that concern you.

Nurtec ODT (rimegepant) is classified as a calcitonin gene-related peptide receptor (CGRP) antagonist (gepant) and is used for the acute treatment of migraine (with or without aura) or the prevention of episodic migraines in adults. It is manufactured by Pfizer Inc.

Which migraine treatments cause weight gain?

Weight gain was not listed as a possible side effect of CGRP inhibitors and does not appear in clinical safety studies submitted to the FDA for migraine treatment or prevention.

Anecdotal reports and surveys have suggested patients may see weight gain with some CGRPs, including Emgality (galcanezumab) or Ajovy. Keep in mind that patients reports are uncontrolled and not of adequate size; therefore, it is hard to know if weight gain was due to the drug, a lifestyle factor, or some other cause.

FDA-approved CGRP inhibitors include injected monoclonal antibodies for prevention of migraine and oral /nasal spray CGRP receptor antagonists [or gepants] for treatment or prevention of migraine:

Monoclonal antibodies:

• Aimovig (erenumab-aooe)
• Ajovy (fremanezumab-vfrm)
• Emgality (galcanezumab)
• Vyepti (eptinezumab-jjmr)

CGRP receptor antagonists (gepants)

• Nurtec ODT (rimegepant)
• Qulipta (atogepant)
• Ubrelvy (ubrogepant)
• Zavzpret nasal spray (zavegepant)

Interestingly, Qulipta has been reported in studies to cause at least a 7% weight loss in 4% to 5% of patients using this medication.

Related Questions

• How do Ubrelvy, Qulipta and Nurtec compare for migraines?
• What are the new drugs for the treatment of migraines?
• How fast and effective is Nurtec ODT for migraines?

Do older migraine medicines cause weight gain?

Yes, some older medications used for migraine prevention are well-known to lead to weight gain. Many of these medications were originally approved to treat other conditions like high blood pressure (hypertension), depression or seizures (epilepsy).

Later, their use for migraine headaches increased and doctors prescribed them “off-label”, meaning they were prescribed for a generally accepted use not specifically approved by the FDA or listed in package labeling. Some of these treatments are no longer frequently prescribed for migraine because better treatment options are now available.

Examples of migraine medicines that may cause weight gain include:

• amitriptyline
• doxepin
• duloxetine (Cymbalta)
• gabapentin
• metoprolol
• propranolol
• verapamil
• valproate

For example, amitriptyline and doxepin are tricyclic antidepressants (TCAs) used to prevent migraine headaches but can also be associated with weight gain and drowsiness or sedation.

Duloxetine (Cymbalta), a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant used off-label for migraine prevention may lead to weight loss or weight gain.

Verapamil, a calcium channel blocker, and beta blockers like metoprolol (Lopressor) or propranolol (Inderal) are heart and blood pressure medicines used for migraine but may also be associated with weight gain.

Valproate or gabapentin, medicines approved for epilepsy but also used for migraine prevention, can cause weight gain. Some epilepsy medicines, such as protriptyline, topiramate, and zonisamide, have been prescribed off-label for migraine prevention but may actually cause weight loss.

The triptans are used for treatment of acute migraine headache and come in various forms like orla tablets, injection and nasal sprays. In general, this class of migraine treatment is not associated with weight gain, but weight loss is a possible serious side effect of this class.

Prescription medications in the triptan class include:

• almotriptan (Axert, brand discontinued)
• eletriptan (Relpax)
• frovatriptan (Frova)
• naratriptan (Amerge)
• rizatriptan (Maxalt, Maxalt-MLT)
• sumatriptan (Imitrex, Tosymra, Onzetra Xsail, Zembrace Symtouch)
• zolmitriptan (Zomig, Zomig-ZMT)

What does ODT mean in Nurtec ODT?

ODT stands for “orally disintegrating tablet”.

Nurtec ODT (rimegepant) is an “orally disintegrating tablet” (ODT) that comes in a 75 milligram (mg) strength. ODT tablets do not need to be taken with water or swallowed, which may be more convenient for you.

Once you have removed the Nurtec ODT tablet from the blister pack, place it on or under your tongue. It will dissolve and no water or other drink is needed.

The maximum dose in a 24-hour period is 75 mg. In addition, the safety of treating more than 18 migraines in a 30-day period has not been established.

Related: List of FDA-Approved CGRP migraine medications

Bottom Line

Weight gain has not been reported in clinical studies as a side effect with Nurtec ODT. Some patients report weight gain with certain CGRP inhibitors, but it is difficult to determine the validity of these reports due to their uncontrolled nature.

Other factors related to migraine, such as lack of exercise due to chronic headache pain, altered eating schedules, or changes in diet may play a role in weight gain.

Older medicines from various drug classes, such as amitriptyline, verapamil or valproate, can be linked with weight gain. Talk to your doctor if weight gain with migraine medicines is a side effect you are concerned about.

This is not all the information you need to know about Nurtec ODT for safe and effective use and does not replace your healthcare provider’s directions. Review the full product information here, and discuss this information with your doctor or other health care provider.