Via practica 3-4/2026

Rimegepant in the acute and preventive treatment of migraine

Migraine is among the most common neurological disorders and significantly reduces quality of life. In addition to non- -specific and specific acute treatment as well as preventive strategies, targeted therapies acting on the calcitonin gene-related peptide (CGRP) system have been increasingly implemented in recent years. Rimegepant is an oral CGRP receptor antagonist indicated for the acute and preventive treatment of migraine. Despite the broad range of options for acute therapy (NSAIDs, triptans, and others), the use of triptans is limited in some patients due to contraindications, insufficient efficacy, or poor tolerability. From a safety perspective, rimegepant is considered a therapeutic alternative without a vasoconstrictive mechanism, which may be advantageous particularly in patients with cardiovascular risk factors. Its efficacy has also been demonstrated in migraine prevention, thereby expanding the spectrum of prophylactic options alongside monoclonal antibodies targeting CGRP. The aim of this review article is to summarize the available evidence on the efficacy and safety of rimegepant in clinical trials as an additional agent broadening the possibilities for both acute and preventive migraine treatment.

Keywords: migraine, CGRP, rimegepant, acute treatment, prevention, triptans, safety