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Gepants: rimegepant and atogepant

Gepants block the CGRP receptor. In Australia, rimegepant is approved for acute and preventive use in adults, while atogepant is approved for migraine prevention in adults with at least four migraine days per month.

About 2 min read · Australian context where available
Checking review recordSource references are available below.
KEY POINTS

The short version.

01

Rimegepant can be used acutely and preventively

02

Atogepant is a preventive treatment

03

Availability and funding can differ from TGA approval

In this guide · 7 sections

Rimegepant

The TGA has approved rimegepant for acute treatment of migraine with or without aura in adults and preventive treatment of episodic migraine in adults with at least four attacks per month.

Atogepant

The TGA has approved atogepant for migraine prevention in adults who have at least four migraine days per month. Treatment suitability, dose and access need a prescriber.

Where gepants: rimegepant and atogepant fits

This Clea guide places gepants: rimegepant and atogepant in the broader migraine treatment landscape. The important distinction is whether it is used for an attack, prevention, symptom support, rehabilitation or another specific care goal.

Treatment choice is individual. The role of a therapy depends on the migraine pattern, other health conditions, pregnancy or breastfeeding, interactions, previous treatment experience, access and a clinician's assessment.

Evidence and limitations

Clea separates evidence from popularity. Randomised trials, systematic reviews, guidelines, observational studies and patient experiences do not carry the same weight. Where evidence is limited or indirect, we say so rather than presenting uncertainty as a recommendation.

Australian access

Australian availability can involve TGA registration, prescription requirements, PBS restrictions, private access, specialist criteria or device availability. Those details can change, so Clea links to current official sources and keeps access separate from whether a treatment is clinically suitable for you.

Safety and suitability

Do not start, stop, combine or change a medicine because of a Clea page or a community experience. Side effects, contraindications and interactions need to be considered with a GP, neurologist or pharmacist who knows your medical history.

What to track in Clea

Record headache or migraine days, severity, associated symptoms, medicines used and the context around the episode. Several weeks of consistent observations are usually more useful than trying to prove a cause from one attack.

  • Headache and migraine-like days
  • Severity and function
  • Associated symptoms
  • Acute medicine days
  • Anything that changed around the pattern
SOURCES AND FURTHER READING

Go to the original sources.

Medicine and treatment information changes.

Clea checks source material, but PBS listings, medicine information and treatment access can change. Confirm current details with the TGA, PBS, your pharmacist or treating clinician.

How Clea sources and reviews migraine information →
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