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Qulipta
atogepant
Adult Dosing .
Dosage forms: TAB: 10 mg, 30 mg, 60 mg
migraine prophylaxis, episodic
- [10-60 mg PO qd]
migraine prophylaxis, chronic
- [60 mg PO qd]
renal dosing
- [migraine prophylaxis, episodic]
- CrCl <30: 10 mg qd
- HD: 10 mg qd, on dialysis days admin. after dialysis; no supplement; PD: not defined
- [migraine prophylaxis, chronic]
- CrCl <30: avoid use
- HD: avoid use; PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class C: avoid use
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hepatic impairment, Child-Pugh Class C
- CrCl <30 (chronic migraine prophylaxis use)
- caution: CrCl <30 (episodic migraine prophylaxis use)
- caution: HTN
- caution: Raynaud phenomenon
Drug Interactions .
Overview
atogepant
CGRP antagonist
- CYP3A4 substrate
- OATP1B1 substrate
- OATP1B3 substrate
- hypertensive effects
Avoid/Use Alternative
- apalutamide
- armodafinil
- artemether/lumefantrine
- atogepant
- belzutifan
- bexarotene
- bosentan
- brigatinib
- butalbital
- carbamazepine
- cenobamate
- clobazam
- dabrafenib
- danshen
- darolutamide
- dexamethasone
- dicloxacillin
- echinacea
- efavirenz
- elafibranor
- elagolix
- enasidenib
- encorafenib
- enzalutamide
- epinephrine inhaled
- eptinezumab
- erenumab
- eslicarbazepine acetate
- etravirine
- felbamate
- fexinidazole
- fosamprenavir
- fosphenytoin
- fremanezumab
- furosemide
- galcanezumab
- garlic
- ginkgo
- ginseng, Asian
- glycerol phenylbutyrate
- griseofulvin
- ivosidenib
- lopinavir/ritonavir
- lorlatinib
- lumacaftor/ivacaftor
- mavacamten
- midodrine
- mitapivat
- mitotane
- mobocertinib
- modafinil
- nafcillin
- nevirapine
- odevixibat
- olutasidenib
- omaveloxolone
- oxcarbazepine
- pacritinib
- pentobarbital
- perampanel
- pexidartinib
- phenobarbital
- phenytoin
- pioglitazone
- prednisone
- primidone
- repotrectinib
- rifabutin
- rifampin
- rifapentine
- rimegepant
- rufinamide
- sarilumab
- sotorasib
- St. John's wort
- stiripentol
- sunvozertinib
- suzetrigine
- tazemetostat
- tecovirimat
- tocilizumab
- topiramate
- tovorafenib
- ubrogepant
- vamorolone
- vemurafenib
- vinblastine
- vorasidenib
- zanubrutinib
- zavegepant
Monitor/Modify Tx
- abiraterone acetate
- acebutolol
- adagrasib
- albuterol
- albuterol inhaled
- aliskiren
- almotriptan
- amiloride
- amlodipine
- amphetamine
- angiotensin II
- aprocitentan
- arformoterol inhaled
- asciminib
- atazanavir
- atenolol
- atomoxetine
- atropine ophthalmic
- axitinib
- azilsartan medoxomil
- belumosudil
- bempedoic acid
- benazepril
- benzphetamine
- betamethasone
- betaxolol
- bevacizumab
- bismuth subsalicylate
- bisoprolol
- budesonide
- bumetanide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- candesartan cilexetil
- cannabis
- captopril
- carfilzomib
- carvedilol
- ceftobiprole
- celecoxib
- ceritinib
- chloramphenicol
- chlorothiazide
- chlorthalidone
- clarithromycin
- clevidipine
- clonidine
- clopidogrel
- cobicistat
- cocaine
- copanlisib
- corticotropin
- cortisone
- cyclosporine
- danazol
- darbepoetin alfa
- darunavir
- deflazacort
- desmopressin
- desvenlafaxine
- dexmethylphenidate
- dextroamphetamine
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- dihydroergotamine
- diltiazem
- dobutamine
- dopamine
- doxapram
- doxazosin
- dronabinol
- droxidopa
- eletriptan
- eltrombopag
- eluxadoline
- enalapril
- enalaprilat
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- eplerenone
- epoetin alfa
- ergotamine
- erythromycin
- esketamine
- esmolol
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethacrynic acid
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- felodipine
- fenfluramine
- fenoldopam
- fenoprofen
- fingolimod
- fludrocortisone
- flurbiprofen
- formoterol inhaled
- fosinopril
- fostamatinib
- fostemsavir
- frovatriptan
- fruquintinib
- gemfibrozil
- glecaprevir
- guanfacine
- hoodia
- hydralazine
- hydrochlorothiazide
- hydrocortisone
- ibrutinib
- ibuprofen
- idelalisib
- indapamide
- indomethacin
- irbesartan
- isradipine
- itraconazole
- ketamine
- ketoconazole
- ketoprofen
- ketorolac
- labetalol
- lanreotide
- leflunomide
- leniolisib
- lenvatinib
- letermovir
- levalbuterol inhaled
- levoketoconazole
- levomilnacipran
- licorice
- lisdexamfetamine
- lisinopril
- lonafarnib
- losartan
- luspatercept
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylergonovine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- metolazone
- metoprolol
- midostaurin
- mifepristone
- milnacipran
- minoxidil
- mirabegron
- moexipril
- nabumetone
- nadolol
- naproxen
- naratriptan
- naxitamab
- nebivolol
- nefazodone
- nelfinavir
- nicardipine
- nifedipine
- nimodipine
- niraparib
- nisoldipine
- norepinephrine
- olmesartan medoxomil
- olodaterol inhaled
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pazopanib
- perindopril
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pibrentasvir
- pindolol
- piroxicam
- ponatinib
- ponesimod
- posaconazole
- pralsetinib
- prazosin
- prednisolone
- propranolol
- pseudoephedrine
- quetiapine
- quinapril
- ramipril
- ramucirumab
- regorafenib
- resmetirom
- ribociclib
- ripretinib
- ritonavir
- rizatriptan
- ropinirole
- rotigotine transdermal
- sacubitril
- salmeterol inhaled
- salsalate
- selpercatinib
- siponimod
- solriamfetol
- sorafenib
- spironolactone
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- telmisartan
- terazosin
- terbutaline
- teriflunomide
- testosterone
- timolol
- tipranavir
- tivozanib
- tolmetin
- torsemide
- trametinib
- trandolapril
- triamcinolone
- triamterene
- tucatinib
- vadadustat
- valsartan
- vandetanib
- vasopressin
- velpatasvir
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- voclosporin
- voriconazole
- voxilaprevir
- yohimbe
- ziv-aflibercept
- zolmitriptan
Caution Advised
- elexacaftor/tezacaftor/ivacaftor
- meropenem
- pretomanid
- trofinetide
- vaborbactam
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- angioedema
- HTN
- Raynaud phenomenon
Common Reactions
- nausea
- constipation
- weight decr.
- fatigue
- somnolence
- appetite decr.
- dizziness
- ALT or AST elevated
Safety/Monitoring .
Monitoring Parameters
Cr at baseline; BP
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; possible risk of decr. fetal wt and skeletal ossification based on animal data at >4x MRHD and risk of fetal visceral or skeletal abnormalities based on animal data at >3x MRHD
Pregnancy Registry
encourage patients to enroll in Empress Pregnancy Registry at 1-833-277-0206 or www.empresspregnancyregistry.com
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm, though drug excreted into milk; no human data available to assess effects on milk production
Pharmacology .
Metabolism: unknown; CYP450: 3A4 substrate
Excretion: feces 42% (100% unchanged), urine 5% (100% unchanged); Half-life: 11h
Subclass: CGRP Inhibitors ; Headache/Migraine
Mechanism of Action
blocks calcitonin gene-related peptide (CGRP) activity
Formulary .
No Formulary Selected
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