Migraine Prevention Guidelines

Introduction to Qulipta (Atogepant)

The American College of Physicians recommends Qulipta (atogepant) as a second-line therapy for migraine prevention, after first-line options such as beta-blockers, valproate, venlafaxine, or amitriptyline have been considered 1
Qulipta (atogepant) is a CGRP antagonist that can be used when patients do not tolerate or inadequately respond to first-line therapies, according to the American College of Physicians guidelines 1
The American College of Physicians guidelines suggest topiramate as a third-line option for patients who fail both first and second-line therapies 1

Qulipta (atogepant) is available in 10mg, 30mg, and 60mg doses for episodic migraine, and 60mg once daily is approved for chronic migraine, with oral administration being the preferred method for many patients 1
The American College of Physicians guidelines note that Qulipta (atogepant) can be taken orally once daily, which may be suitable for patients who prefer oral therapy over injections 1

The American College of Physicians guidelines acknowledge that Qulipta (atogepant) has a higher cost compared to traditional preventive medications like beta-blockers, antidepressants, and antiseizure medications 1
The guidelines also note that Qulipta (atogepant) is a relatively new medication with limited long-term safety data compared to older preventives 1

The American College of Physicians guidelines recommend starting with first-line agents (beta-blockers, valproate, venlafaxine, or amitriptyline) due to lower cost and established safety profile 1
The guidelines suggest considering Qulipta (atogepant) if a patient fails or cannot tolerate first-line agents 1