Rimegepat is a calcitonin gene-related peptide (CGRP) receptor antagonist primarily used for acute and prophylactic treatment of adult migraine. The medication should pay attention to liver function monitoring, drug interactions, and adjustments for special populations, and strictly follow dosage limits and dosing intervals.

1. Indications

(1) Acute treatment

Suitable for acute treatment of migraine attacks in adults with or without aura, it can alleviate headaches and related symptoms such as nausea, photophobia, etc. Single administration of 75mg, with a maximum dose not exceeding 75mg within 24 hours.

(2) Preventive treatment

For the prevention of adult episodic migraine, take 75mg orally every 2 days. It should be noted that preventive treatment should be evaluated for efficacy for at least 3 months.

2. Medication precautions

(1) Dose limit

The dosage should not exceed 75mg within 24 hours, and the monthly treatment should not exceed 18 doses. Excessive intake may increase the risk of liver dysfunction.

(2) Liver function monitoring

Prohibited for individuals with moderate to severe liver function impairment. Mild impairment patients should use with caution and regularly monitor ALT/AST levels during treatment.

(3) Drug interactions

Avoid combination therapy with potent CYP3A4 inhibitors. Combined use with P-gp or BCRP inhibitors may increase exposure to remifentanil.

(4) Special populations

The safety during pregnancy has not been established, and breastfeeding should be suspended. Elderly people aged 65 and above need to undergo liver function assessment before use.

(5) Adverse reaction management

Common reactions such as nausea and dizziness are usually mild. If there is an allergic reaction or abnormal liver function, stop taking medication immediately and seek medical attention.

(6) Administration method

Oral disintegrating tablets should be dissolved on the tongue without the need for drinking water. Avoid taking with high-fat meals to avoid affecting absorption.