Gepants are a class of small-molecule, orally administered calcitonin gene-related peptide (CGRP) receptor antagonists developed for the acute treatment of migraine.
- Mechanism: They block the CGRP receptor, preventing the vasodilation and neurogenic inflammation associated with migraine.
- Examples:
- Rimegepant (Nurtec ODT) – FDA-approved for acute migraine.
- Ubrogepant (Ubrelvy) – FDA-approved for acute migraine.
- Rationale: Gepants offer an alternative to triptans, with a favorable side-effect profile (e.g., no vasoconstriction) and potential for use in patients with cardiovascular risk factors.
- Guidelines: Recommended in the 2021 AHS guidelines for acute migraine treatment, particularly for patients with contraindications to triptans.