Qulipta is for Prevention, Not Acute Treatment
Qulipta (atogepant) is a daily oral medication specifically approved for the preventative treatment of episodic and chronic migraine. Its purpose is to reduce the frequency and severity of future migraine attacks, not to stop an attack that has already begun. Its mechanism is different from that of acute treatments, as it works to prevent the underlying migraine process rather than halting it mid-symptom.
How Qulipta Works as a Preventative
Qulipta functions by blocking the calcitonin gene-related peptide (CGRP) receptor. CGRP is a protein naturally found in the nervous system that plays a significant role in causing the pain, inflammation, and dilation of blood vessels associated with migraine attacks. By blocking the CGRP receptor, Qulipta helps prevent the activation of these pain pathways, thereby reducing the number of migraine days a person experiences over time. This process requires consistent, long-term use to be effective, which is why it is taken once daily.
What to Do During an Active Migraine Attack
If you have an active migraine attack while taking Qulipta daily, you should not take an additional dose. Instead, you can and should use a separate medication designed for acute treatment. It is important to have a plan in place with your healthcare provider for managing these breakthrough attacks. Common acute treatments include:
- Triptans: Prescription medications like sumatriptan, rizatriptan, and eletriptan.
- NSAIDs: Over-the-counter or prescription nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen.
- Other Gepants: Certain CGRP receptor antagonists, such as Nurtec ODT (rimegepant) or Ubrelvy (ubrogepant), are approved for acute treatment. However, combining gepants should be done under a doctor's supervision.
- Other Options: Your doctor may recommend other treatments based on your specific symptoms and medical history.
Qulipta vs. Acute Migraine Medications: A Comparison
| Feature | Qulipta (Preventative) | Acute Migraine Medication (e.g., Triptan) |
|---|---|---|
| Purpose | Reduce the frequency and severity of migraines over time. | Stop or reduce symptoms of an ongoing migraine attack. |
| Dosing Schedule | Taken once daily, every day, for long-term prevention. | Taken as needed during a migraine attack. |
| Mechanism of Action | Blocks CGRP receptors to prevent the signaling cascade that leads to a migraine. | Works differently, often by constricting blood vessels and blocking pain pathways. |
| Impact on Active Migraine | No effect on an active migraine; does not relieve symptoms once they begin. | Designed to relieve an active migraine attack and its symptoms. |
| Timing of Effect | Takes weeks to build up and achieve full preventative effect. | Works relatively quickly to provide relief during an attack. |
Consistency is Crucial for Qulipta’s Efficacy
Because Qulipta works preventatively, consistency is the key to its success. Taking your dose at approximately the same time each day helps maintain a steady level of the medication in your system. This steady state is what allows it to effectively block CGRP receptors and provide ongoing protection against migraine attacks. Missing doses can compromise its preventative benefits. If you miss a dose, you should follow your doctor's instructions, which typically involve taking it as soon as you remember unless it's nearly time for your next dose.
Consultation with a Healthcare Provider
Navigating migraine treatment requires a personalized approach. It is essential to work closely with your healthcare provider to develop a comprehensive plan that includes both preventative and acute treatments. Your doctor can help determine the appropriate dosage of Qulipta for your specific condition (episodic or chronic migraine) and can recommend the best acute treatment options for when an attack occurs. During your consultation, be sure to discuss all medications and supplements you are taking to avoid potential drug interactions. For more information on CGRP inhibitors, see the American Migraine Foundation's resources.
Conclusion
In summary, while Qulipta has proven to be an effective preventative treatment for reducing migraine frequency and severity, it is not a rescue medication for active attacks. If you are already experiencing a migraine, you should use your prescribed acute medication, not an additional dose of Qulipta. Maintaining consistency with your daily Qulipta regimen is crucial for achieving its preventative benefits. By understanding the distinct roles of preventative and acute treatments, you can work with your healthcare provider to manage your migraines effectively and improve your quality of life.
