Understanding Ubrelvy and Qulipta
Ubrelvy (ubrogepant) and Qulipta (atogepant) are both oral medications that belong to a class of drugs known as calcitonin gene-related peptide (CGRP) receptor antagonists, or "gepants" [1.5.1, 1.6.2]. CGRP is a protein that is known to be involved in the process of migraine attacks. These medications work by blocking the CGRP receptor, helping to manage migraine symptoms [1.5.1, 1.6.2].
Despite being in the same drug class, they serve two distinct purposes:
- Qulipta (atogepant) is a preventive medication taken once daily to reduce the frequency of both episodic and chronic migraine headaches [1.6.4, 1.6.5].
- Ubrelvy (ubrogepant) is an acute or "abortive" medication taken as needed to treat a migraine attack that is already in progress [1.5.4]. It is not indicated for preventive treatment [1.5.4].
The Core Question: Can I take Ubrelvy if I take Qulipta?
Recent clinical studies have specifically investigated the safety of using these two medications together. The TANDEM study, a phase 4 clinical trial, evaluated the safety and tolerability of taking Ubrelvy 100 mg as needed for breakthrough migraine attacks while also taking Qulipta 60 mg once daily for prevention [1.4.1]. The study's conclusion was that this concomitant use was safe and well-tolerated over a 12-week period [1.4.1, 1.4.3]. The research found no new safety signals or an increase in the frequency or severity of adverse events compared to the known safety profiles of each drug when used alone [1.4.1].
Another pharmacokinetic study found that while taking the two drugs together can slightly increase the concentration of Ubrelvy in the body, the changes were not considered clinically meaningful, and no new safety concerns were identified for the combination [1.4.7]. While interaction checkers may state that no interactions were found, they often include the crucial caveat that this does not mean none exist and that a healthcare provider should always be consulted [1.3.1, 1.4.5].
Crucially, this combination therapy should only be undertaken under the direct supervision and recommendation of a healthcare professional. They can assess your individual health status, including liver and kidney function, and other medications you are taking to determine if this approach is appropriate for you [1.3.5].
Potential Risks and Side Effects
Both Ubrelvy and Qulipta are metabolized (processed) by the liver, primarily by an enzyme called CYP3A4 [1.3.6, 1.6.2]. Taking them with other drugs that inhibit or induce this enzyme can affect their concentration in the body, potentially leading to reduced efficacy or an increased risk of side effects [1.5.1, 1.6.2].
The most common side effects reported in the TANDEM combination study were generally consistent with the side effects of the individual drugs, including [1.4.1]:
- Nausea
- Constipation
- Fatigue/Somnolence
- Decreased appetite
Neither Ubrelvy nor Qulipta have been linked to significant liver toxicity in clinical trials, a concern with earlier CGRP antagonists [1.3.7, 1.3.12]. However, dose adjustments may be necessary for patients with severe liver or kidney impairment [1.5.3, 1.6.3].
Ubrelvy vs. Qulipta: A Head-to-Head Comparison
| Feature | Ubrelvy (ubrogepant) | Qulipta (atogepant) |
|---|---|---|
| Primary Use | Acute treatment (as needed) [1.5.4] | Preventive treatment (daily) [1.6.2] |
| Drug Class | CGRP Receptor Antagonist (Gepant) [1.5.1] | CGRP Receptor Antagonist (Gepant) [1.6.2] |
| How It's Taken | Oral tablet at the onset of a migraine [1.5.1] | Oral tablet once daily [1.6.2] |
| Common Side Effects | Nausea, somnolence (sleepiness) [1.5.4] | Nausea, constipation, fatigue/somnolence [1.6.3] |
| Dosage Forms | 50 mg and 100 mg tablets [1.5.4] | 10 mg, 30 mg, and 60 mg tablets [1.6.2] |
| Use with Severe Liver Impairment | Dose adjustment recommended [1.5.8] | Avoid use [1.6.2] |
Talking To Your Doctor
Before starting this or any new medication regimen, it's vital to have an open discussion with your healthcare provider. Be prepared to discuss:
- The frequency and severity of your migraine attacks.
- All other medications you take, including over-the-counter drugs, vitamins, and supplements like St. John's Wort [1.5.1].
- Your consumption of grapefruit juice, as it can interact with Ubrelvy [1.5.3].
- Any history of liver or kidney problems [1.3.5].
- Any history of hypertension or Raynaud's phenomenon [1.5.9, 1.6.9].
Conclusion
Based on current clinical trial data, it can be safe for some patients to take Ubrelvy for acute migraine attacks while taking Qulipta for prevention [1.4.2]. This dual-gepant therapy has been studied and found to be well-tolerated without new or increased safety risks [1.4.1]. However, the decision to use both medications concurrently is a medical one that must be made by a qualified healthcare provider. They will weigh the potential benefits against the risks for your specific situation. Never start, stop, or combine medications without consulting your doctor first.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional for diagnosis and treatment.
