Nurtec™ ODT

Drug - Nurtec™ ODT (rimegepant) [Biohaven Pharmaceuticals, Inc.]

July 2020

Therapeutic area - Antimigraine Agents, Other

Initial approval criteria:

Patient must be ≥ 18 years of age; AND
Patient must have a diagnosis of migraine, with or without aura; AND
Patient must NOT have headache frequency ≥ 15 headache days per month during the prior 6 months [indication is for acute use only]; AND
Provider must provide an attestation to all of the following:
- Provider has provider administration instructions for Nurtec ODT to the patient; AND
- If applicable, provider has completed a review of patient’s adherence of any medication used to prevent migraine and address any patient’s adherence issue; AND
Patient must NOT be concurrently using strong CYP3A4 inhibitors, strong or moderate CYP3A inducers, or P-gp or BCRP inhibitors; AND
Patient must not have end-stage renal disease (CLcr < 15 mL/min) or on dialysis; AND
Patient must have tried and failed at least one of the following: NSAID, non-opioid analgesic, acetaminophen OR caffeinated analgesic combination; AND
Patient must have tried and failed, or has a contraindication or intolerance to 2 preferred triptans.

Continue to meet initial criteria; AND
Patient is experiencing symptom improvement; AND
The patient is not experiencing any treatment-limiting adverse reactions of the medication

15 tablets per 30 days
Any request for quantities exceeding those recommended by the FDA will not be approved

FDA-approved label states:

The maximum dose in a 24-hour period is 75mg,
The safety of treating more than 15 migraines in a 30-day period has not been established.

MHCP Provider Call Center 651-431-2700 or 1-800-366-5411