Investigating a Key Question: Does Qulipta Cause High Blood Pressure?

October 8, 2025 •

4 min read

Migraine is a highly prevalent neurological disorder affecting approximately 12% to 15% of the global population [1.8.4, 1.8.6]. For those prescribed Qulipta for prevention, a common question arises: Does Qulipta cause high blood pressure? The answer is yes, it is a potential side effect [1.2.2, 1.2.3].

Quick Summary

Qulipta (atogepant) is a medication for migraine prevention. Post-marketing reports confirm that new onset or worsening of high blood pressure (hypertension) is a possible serious side effect [1.4.3, 1.6.2].

Key Points

Hypertension Risk: Yes, Qulipta can cause new or worsening high blood pressure (hypertension) as a serious side effect [1.2.2, 1.4.3].
Mechanism: Qulipta is a CGRP receptor antagonist that works by blocking a protein involved in migraine attacks to prevent them [1.5.3, 1.5.5].
Timing: The increase in blood pressure is most frequently reported within 7 days of starting treatment with Qulipta [1.6.2].
Monitoring is Key: Healthcare providers are advised to monitor patients for changes in blood pressure after they start taking Qulipta [1.4.3].
Common Side Effects: The most common adverse reactions to Qulipta are nausea, constipation, and fatigue or sleepiness [1.4.2].
Other Serious Risks: Besides hypertension, other serious risks include severe allergic reactions and Raynaud's phenomenon (a circulation issue) [1.2.3, 1.6.2].
Patient History: Patients with a history of hypertension, Raynaud's, or severe kidney/liver issues should discuss these with their doctor before starting Qulipta [1.2.5, 1.6.1].

Understanding Qulipta and its Function

Qulipta, with the active drug atogepant, is an oral medication approved for the preventive treatment of both episodic and chronic migraine in adults [1.6.1]. It belongs to a class of drugs known as calcitonin gene-related peptide (CGRP) receptor antagonists, or "gepants" [1.5.3]. CGRP is a protein in the nervous system that is understood to play a key role in the process of a migraine attack, contributing to pain and inflammation [1.5.1, 1.5.5]. By blocking the CGRP receptor, Qulipta helps to prevent migraine headaches from starting [1.5.3]. It is taken as a once-daily tablet, offering a preventive option for those who experience frequent migraine attacks [1.6.1].

The Link Between Qulipta and Hypertension

While clinical trials did not initially report hypertension as a common side effect, post-marketing surveillance has identified a clear connection [1.2.7, 1.4.3]. The official prescribing information for Qulipta now includes a warning about the development of hypertension and the worsening of pre-existing hypertension [1.6.2].

These cardiovascular events have been reported following the use of CGRP antagonists, including Qulipta [1.4.4]. Reports indicate that hypertension can occur at any time during treatment, but it is most frequently observed within the first seven days of starting the medication [1.6.2]. In some instances, the high blood pressure was serious enough to require starting new blood pressure medication or even hospitalization [1.4.3]. For many of the reported cases, the hypertension resolved after discontinuing Qulipta [1.6.2].

It is crucial for patients, especially those with pre-existing risk factors for hypertension, to be aware of this potential side effect. Healthcare providers are advised to monitor patients for new-onset hypertension or a worsening of their current condition after starting Qulipta [1.4.3].

Common and Serious Side Effects of Qulipta

Beyond blood pressure concerns, Qulipta has a range of potential side effects. The most common adverse reactions reported in clinical trials (affecting 4% or more of patients and more than placebo) include:

Nausea [1.4.2]
Constipation [1.4.2]
Fatigue/Somnolence (sleepiness) [1.4.2]

Other reported side effects include decreased appetite and dizziness [1.6.2]. Weight loss of 7% or more has also been observed in a small percentage of patients, particularly at the highest dose [1.6.1].

More serious side effects, though less common, require immediate medical attention:

High Blood Pressure (Hypertension): As discussed, new or worsening high blood pressure can occur [1.2.2]. Symptoms may include blurred vision, dizziness, headache, or a pounding in the ears [1.2.1].
Serious Allergic Reactions (Hypersensitivity): These can include anaphylaxis, which is life-threatening. Symptoms like swelling of the face, lips, or tongue, trouble breathing, itching, or hives can happen days after taking the medication and require emergency help [1.2.3, 1.6.2].
Raynaud's Phenomenon: This is a problem with blood circulation, typically in the fingers and toes. It can cause numbness, pain, a cold feeling, or color changes in the skin when exposed to cold [1.2.1, 1.2.3]. This side effect can also be serious and may require discontinuation of the drug [1.6.2].
Liver Enzyme Elevations: While not common, cases of elevated liver enzymes have been reported that were associated with Qulipta use. These were typically asymptomatic and resolved after stopping the medication [1.6.1].

Comparing CGRP Inhibitors

Qulipta is one of several CGRP inhibitors available for migraine. Others include Nurtec ODT (rimegepant) and Ubrelvy (ubrogepant). When comparing them, side effect profiles show some overlap.


Feature	Qulipta (atogepant)	Nurtec ODT (rimegepant)	Ubrelvy (ubrogepant)
Primary Use	Migraine Prevention [1.5.3]	Acute Treatment & Prevention [1.7.2]	Acute Treatment [1.7.1]
Common Side Effects	Nausea, constipation, fatigue [1.4.2]	Nausea, stomach pain/indigestion [1.7.2]	Nausea, drowsiness, dry mouth [1.7.3]
Reported Nausea	5%–9% [1.7.1]	~2% (acute), 2.7% (preventive) [1.7.1]	2%–4% [1.7.1]
Cardiovascular Warning	Hypertension, Raynaud's Phenomenon [1.6.2]	Allergic reactions noted as rare but serious [1.7.3]	Allergic reactions noted as rare but serious [1.7.3]

All three medications are generally well-tolerated, with nausea being a shared side effect [1.7.1]. However, the official warnings regarding hypertension and Raynaud's phenomenon are specifically highlighted for Qulipta based on post-marketing reports for the CGRP antagonist class [1.6.2].

Patient Considerations and Management

Before starting Qulipta, patients should discuss their complete medical history with their doctor. This is especially important for individuals with:

Pre-existing high blood pressure or risk factors for it [1.2.5]
A history of Raynaud's phenomenon [1.2.5]
Severe kidney or liver problems [1.6.1]
A history of hypersensitivity to atogepant or its components [1.6.1]

Patients should also inform their doctor of all other medications they are taking, including over-the-counter drugs, supplements, and herbal products like St. John's wort, as drug interactions can occur [1.6.4, 1.2.1]. Grapefruit and grapefruit juice should also be avoided as they can increase drug levels in the body, potentially raising the risk of side effects [1.6.4].

If a patient experiences symptoms of high blood pressure, such as headaches, dizziness, or blurred vision, they should contact their healthcare provider right away [1.2.1]. The provider will monitor the patient's blood pressure and determine if Qulipta should be discontinued [1.4.3].

Conclusion

So, does Qulipta cause high blood pressure? Yes, the development of new or worsening high blood pressure is a recognized potential serious side effect of Qulipta, as noted in its updated warnings based on post-marketing data [1.4.3, 1.6.2]. While the most common side effects are generally milder gastrointestinal issues and fatigue, the cardiovascular risk is a critical consideration [1.4.2]. Patients and healthcare providers must work together to monitor for any signs of increased blood pressure, especially early in treatment. This vigilance ensures that the benefits of preventing debilitating migraines with Qulipta are safely balanced against its potential risks.

For more detailed safety information, you can review the FDA's prescribing information for Qulipta. [1.6.1]

Frequently Asked Questions

Symptoms of high blood pressure can include blurred vision, dizziness, a new or unusual headache, nervousness, or a pounding sound in your ears. You should contact your doctor right away if you experience any of these [1.2.1].

High blood pressure is listed as a serious, but not common, side effect. It was identified in post-marketing reports rather than being a frequent occurrence in initial clinical trials [1.2.6, 1.2.7]. The most common side effects are nausea, constipation, and fatigue [1.4.2].

You should discuss this with your doctor. Worsening of pre-existing hypertension has been reported with Qulipta. Your doctor will need to monitor your blood pressure closely if you start this medication [1.2.2, 1.6.2].

Qulipta is a CGRP receptor antagonist. It works by blocking the activity of a protein called calcitonin gene-related peptide (CGRP), which is known to be involved in the inflammation and pain of migraine attacks [1.5.3, 1.5.5].

If you experience mild side effects, talk to your doctor. For serious symptoms like trouble breathing, swelling of the face or tongue, or signs of high blood pressure, you should stop taking Qulipta and seek emergency medical help immediately [1.2.2, 1.2.3].

Yes, you should avoid grapefruit and grapefruit juice, as they can increase the levels of Qulipta in your body. Also, inform your doctor of all other medications and supplements you take, as some can interact with Qulipta [1.6.4].

In many of the reported cases, the high blood pressure resolved after the medication was discontinued. If you develop hypertension, your doctor will evaluate the situation and decide if stopping Qulipta is the right course of action [1.6.2].