Acute treatment with Rimegepant, also known as Vydura

The medication 

Vydura is developed specifically for the treatment of migraines. Vydura can be used for acute attacks but is also approved as a preventive treatment for adults with episodic migraine who have at least 4 migraine attacks per month. 

Vydura is not believed to cause medication-overuse headache and can therefore be used for acute attacks beyond the 9 recommended days for, for example, triptans or other painkillers.

Mechanism of action 

It is known that CGRP (calcitonin gene-related peptide), which is produced in our nervous system, plays an active role in a migraine attack.

Rimegepant, the active ingredient in Vydura, is believed to work by binding specifically to the CGRP molecule's receptor, thereby preventing the transmission of pain signals to the brain. This can reduce the frequency and severity of your migraine attacks.

Vydura has a half-life of approximately 11 hours, which means it is cleared from the body after a few days.

Side effects 

Approximately 1-10% experience nausea. Very rarely (approx. 0.1%), rash and difficulty breathing may occur.

If you experience side effects not mentioned here, please let us know so we can report them to the Danish Medicines Agency.

Precautions 

Vydura must not be used by pregnant or breastfeeding women. 

You must stop taking Vydura at least 5 days before trying to become pregnant.

Vydura should not be used in combination with certain specific medications.

What is the recommended dosage? 

Acute treatment: You should take 1 tablet of 75 mg as early in the attack as possible. You must not take more than 1 Vydura tablet per day.

Preventive: Take one 75 mg tablet every other day. If you have a migraine attack on a day when you have already taken Vydura, either as a preventive or as acute treatment, you may use another acute treatment, such as a triptan.

How should Vydura be taken?

Place the tablet under your tongue, where it will dissolve and be swallowed with your saliva. Do not eat or drink for at least 5 minutes after taking it.

Subsidies

Conditional subsidies are available for Vydura as acute treatment if the following criteria are met:
You must be receiving relevant preventive treatment. 

Furthermore, you must have tried at least three different triptans, either without effect or with unacceptable side effects, OR have a contraindication for triptans, including having more than 9 attacks per month requiring treatment.

Subsidies are provided for a maximum of 8 tablets per month.