Ubrogepant

Ubrogepant is an oral medication in the gepant class used for the acute treatment of migraine in adults. It functions as a selective antagonist of the calcitonin gene-related peptide (CGRP) receptor, aiming to reduce CGRP-mediated signaling involved in migraine pain and related symptoms.

The drug is marketed in tablet form at strengths of 50 mg and 100 mg. A single dose is taken at the onset of a migraine; if needed, a second dose may be taken after at least two hours, with a maximum of 200 mg in 24 hours. It is intended for short-term relief and is not a preventive therapy.

Pharmacokinetically, ubrogepant is rapidly absorbed, with peak concentrations reached within a few hours after dosing. It is primarily metabolized in the liver, predominantly by CYP3A4 enzymes, and is eliminated through hepatic and renal pathways. Because of its metabolism, strong inhibitors or inducers of CYP3A4 can alter exposure to ubrogepant, necessitating dose adjustments or avoidance in some cases. Caution is advised in patients with hepatic impairment.

Common adverse events reported in clinical experience include nausea, dry mouth, and dizziness; serious adverse events are uncommon. Rare cases of liver injury have been noted in post-marketing data, leading to guideline-aligned monitoring if ubrogepant is used chronically or in patients with liver concerns.

Regulatory status varies by region. In the United States, ubrogepant received FDA approval in 2019 for the acute treatment of migraine in adults. It is not approved for pediatric use. Related CGRP-targeting therapies include other gepants and CGRP receptor antagonists approved for different migraine indications.