Qulipta (atogepant) is a medication commonly prescribed to prevent migraine in adults. Like all medications, Qulipta can cause side effects, which can range from mild to serious. This article provides a comprehensive overview of the potential side effects of Qulipta, how to manage them, and important considerations before starting treatment.
What is Qulipta and How Does It Work?
Qulipta (atogepant) is an oral medication prescribed by doctors to prevent migraine episodes in adults. It is approved by the Food and Drug Administration (FDA) as a preventive treatment for both episodic and chronic migraines.
Qulipta works by blocking calcitonin gene-related peptide (CGRP), a substance in the brain involved in headache pain and migraine duration. By blocking CGRP, Qulipta helps prevent migraine.
Qulipta is available in 10 mg, 30 mg, and 60 mg oral tablets.
Common Side Effects of Qulipta
The most common side effects of Qulipta include:
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- Nausea
- Constipation
- Fatigue or sleepiness
These side effects are generally mild and temporary, often resolving within a few days to weeks. However, if these symptoms are ongoing or bother you, talk with your doctor or pharmacist.
Clinical trials have provided data on the frequency of these common side effects:
- Nausea: 5% of 10 mg Qulipta users, 6% of 30 mg users, and 9% of 60 mg users.
- Constipation: 6% of 10 mg Qulipta users, 6% of 30 mg users, and 8% of 60 mg users.
- Fatigue/Somnolence: 4% of 10 mg Qulipta users, 4% of 30 mg users, and 5% of 60 mg users.
- Decreased Appetite: 2% of 10 mg Qulipta users, 1% of 30 mg users, and 3% of 60 mg users.
- Dizziness: 2% of 10 mg Qulipta users, 2% of 30 mg users, and 3% of 60 mg users.
Less Common Side Effects of Qulipta
Other less common side effects of Qulipta include:
- Decreased appetite
- Weight loss
- Increased liver enzymes (may indicate liver damage)
Serious Side Effects of Qulipta
Although less common, Qulipta can cause serious side effects, including:
- Severe allergic reactions
- High blood pressure
- Raynaud's phenomenon
Allergic Reactions
Qulipta may cause allergic reactions, which can be serious. These reactions can occur at any time, even several days after taking Qulipta.
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Symptoms of a serious allergic reaction include:
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin (hives)
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
If you experience any of these symptoms, stop taking Qulipta and get medical help right away.
High Blood Pressure
New or worsening high blood pressure has been reported following the use of CGRP antagonists, including Qulipta. Hypertension may occur at any time but was most frequently reported within 7 days of initiation.
Symptoms of high blood pressure may include:
- Severe headache
- Blurred vision
- Dizziness
- Nervousness
- Pounding in the ears
- Slow or fast heartbeat
Check with your doctor right away if you have any of these symptoms within 7 days after starting treatment with Qulipta.
Raynaud's Phenomenon
Raynaud's phenomenon (RP) is a condition that affects blood circulation, particularly in the fingers and toes. Development, recurrence, or worsening of pre-existing RP has been reported following the use of CGRP antagonists, including Qulipta.
Symptoms of Raynaud's phenomenon include:
- Tingling or pain in the fingers or toes when exposed to cold temperatures
- Paleness or a cold feeling in the fingertips and toes
- Skin color change in your fingers (pale, to blue, to red)
Qulipta should be discontinued if signs or symptoms of RP develop, and patients should be evaluated by a healthcare provider if symptoms do not resolve.
Managing Side Effects
During Qulipta treatment, keeping track of any side effects you’re having is important. Share this information with your doctor, especially when you first start taking the drug or using a combination of treatments.
Your side effect notes can include:
- What dose of the drug you were taking when you had the side effect
- How soon you had the side effect after starting that dose
- What your symptoms were
- How it affected your daily activities
- What other medications you were taking
- Any other information you feel is important
For specific side effects, here are some management tips:
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Nausea
- What might help: If you have nausea while taking Qulipta, tell your doctor. They may recommend ways to reduce this side effect. In some cases, they may recommend taking a lower dose of Qulipta to see whether this reduces your nausea. Nausea may reduce with time, but if it becomes intolerable, your doctor may consider other migraine treatment options for you.
- Taking Qulipta with food may help reduce nausea.
Constipation
- What may help: If you have constipation that’s severe or bothersome, talk with your doctor. They’ll be able to suggest ways to reduce this side effect. For example, they may recommend increasing your water consumption or using an over-the-counter medication, such as MiraLax (polyethylene glycol).
- Increasing fiber intake and staying hydrated can also help manage constipation.
Increased Liver Enzymes
- What might help: In studies of Qulipta, people with increased liver enzymes didn’t report liver problem symptoms. So, your doctor may check your blood levels during your treatment. If you do develop symptoms of liver damage, tell your doctor right away. They’ll likely do a blood test to see whether your symptoms are related to your liver enzymes. If they find that your liver enzyme levels have increased, they may have you stop taking Qulipta and try a different migraine prevention treatment.
- Your doctor may monitor your liver enzyme levels with blood tests during treatment.
Important Considerations Before Taking Qulipta
Before using Qulipta, tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Who Should Not Take Qulipta?
Qulipta is contraindicated in individuals with:
- Allergies to atogepant, Qulipta, or any of the ingredients in the specific product dispensed.
- Liver problems: Qulipta should not be used if your liver is not working as well as it should be.
What to Tell Your Healthcare Provider
In particular, make sure that you discuss any of the following with your healthcare provider:
- Current and Past Health Conditions:
- Kidney problems, including if you are on dialysis
- Liver problems
- High blood pressure or risk factors for high blood pressure
- Raynaud phenomenon
- Other Medicines and Supplements: Qulipta may interact with other medicines and supplements.
- Pregnancy: It is not known if or how Qulipta could affect pregnancy or harm an unborn baby.
- Breastfeeding: It is not known if Qulipta passes into breast milk.
Drug Interactions
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Qulipta may interact with the following medications:
- Itraconazole (Sporanox, Tolsura): A medicine used for fungal infections.
- Rifampin: A medicine commonly used to treat tuberculosis.
- Topiramate (Topamax, Trokendi XR, Qudexy XR): A medicine commonly used to treat seizures or prevent migraine.
Avoid grapefruit, grapefruit juice, and any products that contain grapefruit while taking Qulipta.
Alcohol and Qulipta
There are no known interactions between Qulipta and alcohol. However, alcohol can trigger migraine attacks in some people. Also, the risk of sleepiness may be increased if you drink alcohol while taking Qulipta. Consult your healthcare provider for more information and medical advice.
Qulipta Dosages
No, there aren’t unique side effects associated with specific Qulipta doses. In Qulipta’s studies, the same side effects were reported with every dose. However, taking a higher dose of Qulipta, like the 60-mg dose, may be more likely to cause side effects than a lower dose.
It’s important to note that taking higher doses may not be safe if you have certain health conditions. For example, your doctor may prescribe a lower Qulipta dosage if you have a liver or kidney problem. This is because certain liver and kidney problems may cause Qulipta to build up in your body. In turn, this could increase your risk of side effects.
Other Considerations
Weight Changes
Weight gain wasn’t reported as a side effect by people taking Qulipta in studies. You may experience weight loss from taking this drug because the drug can cause a decrease in appetite and nausea. If you notice unintentional changes in your weight during your treatment, talk with your doctor. They can help you determine what may be causing the weight change.
Hair Loss
No, hair loss wasn’t reported by people taking Qulipta in studies. But other drugs used to help prevent migraine may cause hair loss, including topiramate (Topamax) and divalproex sodium (Depakote). If you notice hair loss during your treatment with Qulipta, talk with your doctor. They can help determine what may be causing it. They may also be able to recommend ways to treat your hair loss, such as with the over-the-counter medication minoxidil (Rogaine).
Dizziness
No, dizziness wasn’t a side effect that people taking Qulipta reported in studies. But it may be a side effect of migraine itself. In addition to severe head pain, migraine can cause symptoms such as dizziness, nausea, or vision changes. If you have dizziness while taking Qulipta, talk with your doctor. They can help determine what may be causing this symptom and suggest the best way to treat it.
Depression or Anxiety
No, neither depression nor anxiety was reported in studies of people taking Qulipta. But some drugs used to prevent migraine, such as divalproex sodium (Depakote), may cause changes in mood, including depression or anxiety. If you notice symptoms of depression or anxiety during your treatment with Qulipta, talk with your doctor.
Pregnancy and Breastfeeding
It’s not known whether it’s safe to take Qulipta during pregnancy or while breastfeeding. At this time, no studies have been done involving pregnant people to see whether the drug is safe. There are also no studies to determine whether Qulipta may be present in human breast milk or what effects the drug may have on a breastfeeding child.
If you’re pregnant, planning to become pregnant, or breastfeeding, talk with your doctor before taking Qulipta. They can help you determine whether it may be safe for you. If you take Qulipta during pregnancy, you might consider signing up for this migraine pregnancy registry.
General Precautions
- Do not take Qulipta unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
- Do not share Qulipta with other people, even if they have the same condition as you. It may harm them.
- Keep Qulipta out of the reach of children.
- Qulipta can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Qulipta affects you.