Qulipta (atogepant) is an oral medication prescribed to adults for the prevention of migraine episodes. While its primary function is to reduce the frequency of migraine attacks, some individuals taking Qulipta have reported weight loss as a side effect. This article explores the connection between Qulipta and weight loss, examining the clinical evidence, potential causes, and what to do if you experience this side effect.
What is Qulipta?
Qulipta (atogepant) is a prescription drug approved by the FDA to prevent migraine attacks in adults. Qulipta works as a calcitonin gene-related peptide (CGRP) antagonist that blocks the effects of the CGRP protein, believed to trigger migraines. It belongs to the gepant drug class, which are small-molecule antagonists that block CGRP.
Common Side Effects of Qulipta
Qulipta comes with various side effects that are important to be aware of before starting. In clinical trials, the most common side effects reported were:
- Constipation
- Dizziness
- Fatigue
- Nausea
- Weight loss
These side effects are often temporary, lasting days to weeks. If they persist, worsen, or concern you, it's important to talk with your doctor or pharmacist.
Weight Loss as a Side Effect: Clinical Evidence
Clinical trials show that Qulipta causes weight loss more often than placebo pills. Yes, you may lose some weight if you are taking Qulipta. Weight loss was observed in all Qulipta studies, which included over 2,600 people.
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- In 12-week trials, people with episodic migraine on a 60-mg dose of Qulipta lost about 1% of body weight, while those with chronic migraine lost around 1.5%.
- In the longer studies, the effect was more noticeable. By around nine months, people on Qulipta had lost close to 2% of their starting weight.
- About one-third of participants experienced at least a 5 percent reduction in weight after taking 60 milligrams (mg) of the drug once daily for a year.
- A total of 34.9 percent of participants had a weight reduction of at least 5 percent from baseline.
- A total of 12.8 percent had a weight reduction of 10 percent or more from baseline.
For someone who weighs 150 pounds, losing 7% of body weight means losing almost 11 pounds. That kind of drop could be a lot for someone trying to manage their weight.
Data from the phase 3 ADVANCE study showed a least square (LS) mean percentage change in body weight of +0.37 in the placebo group after 12 weeks compared with +0.14 (P = 0.4138), -0.61 (P = .0005), and -1.27 (P <.0001), in the atogepant 10-, 30-, and 60-mg groups, respectively.
In ADVANCE, 3.2% of those on placebo demonstrated at least 7% weight loss compared with 4.1%, 2.7%, and 5.7% for the atogepant 10-, 30-, and 60-mg groups, respectively. In contrast, weight gains of at least 7% were found in 2.3%, 1.8%, and 0.0% of those in the respective atogepant groups and 2.7% of those on placebo.
In the open-label extension where the highest dose of atogepant (Qulipta; AbbVie) was observed, 24.1% of participants had at least 7% weight loss compared with 14.7% of those on standard of care.
It’s important to note that the subgroup in the study also had cardiovascular risk factors, including hypertension, dyslipidemia, and elevated BMI.
Read also: In-Depth Guide to Qulipta Side Effects
Potential Causes of Weight Loss with Qulipta
Researchers don’t know for sure why Qulipta causes weight loss, but it seems to be linked to side effects and how long you take it. There’s no definitive reason why Qulipta leads to weight loss. Several factors might contribute:
- Decreased Appetite: Up to 3% of people taking Qulipta may experience decreased appetite. When you’re not hungry, you eat less or even skip meals, which could mean fewer calories.
- Nausea: Up to 9% get nausea on Qulipta. If your stomach’s off, you’re not going to want to eat much. Most people avoid food when they feel sick to their stomach. For some people, this side effect is enough to change their eating habits.
- Dosage and Duration: People on higher doses of Qulipta, like a 60-mg oral tablet, tend to lose more weight than those on lower doses, such as a 10-mg pill. The longer you take it, the more noticeable the effect can be.
Ailani said the weight loss was not associated with improved migraine - e.g., you feel better, so you exercise more.
Managing Weight Loss and Other Side Effects
While taking Qulipta, you may be able to take steps to make side effects easier to manage. If you have side effects that do not go away or become worse, talk with your doctor or pharmacist. They can discuss options for managing side effects or suggest other treatment options.
- If you experience sudden weight loss while taking Qulipta, tell your doctor. They may offer guidance on managing it.
- For nausea: talk with your doctor. They may recommend taking your dose of Qulipta with food to see whether it reduces your nausea. They may also recommend other ways to decrease this side effect.
- For bothersome weight loss: you may want to consider an alternative to Qulipta. These alternatives include other CGRP antagonists, such as Emgality (galcanezumab), Nurtec ODT (rimegepant), and Ubrelvy (ubrogepant). Don’t stop taking your migraine medication without getting medical advice first.
- For nausea: If you have nausea while taking Qulipta, tell your doctor. They may be able to 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.
- For constipation: 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).
If you’re experiencing any unwanted side effects, check the prescribing information and consult a healthcare provider about a potential dosage change.
Other Considerations
- Underlying process: Ailani noted that the individuals who were on atogepant for 52 weeks were more likely to lose slightly more weight than those that remained on it only for 3 months. She said that the underlying process for this weight loss was still being investigated, as it did not appear to be correlated with response or the CGRP-focused mechanism of action.
- Other migraine medications: Some migraine medications are known to cause weight gain, such as the preventive amitriptyline (Elavil) or divalproex sodium (Depakote). There is one other migraine preventive known for causing weight loss: topiramate (Topamax).
Important Considerations Before Taking Qulipta
Before taking Qulipta, discuss your health history with your doctor. Qulipta may not be right for you if you have specific medical conditions or other factors affecting your health. Talk with your doctor if any of the following apply to you:
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- Alcohol consumption
- High blood pressure
- Kidney problems, including dialysis treatment
- Liver problems
- Pregnancy or breastfeeding
- Previous allergic reaction to this or a similar drug
- Raynaud phenomenon (reduced blood flow in the extremities, commonly the hands)
Qulipta Dosage
Take your prescribed dose each day at about the same time, with or without food. Some people feel tired or sleepy when taking Qulipta. If this occurs, ask your healthcare provider if you can take your dose at bedtime. If you feel nauseous, take your daily dose at mealtime.
Qulipta Cost and Availability
The cost of Qulipta depends on your insurance coverage, but the average list price was around $1,147 for a 30-day supply as of January 2025. Manufacturer AbbVie offers a patient savings program for those with commercial insurance. Eligible patients may be able to get the medication at no cost, depending on insurance coverage. Qulipta may be covered by Medicare Part D prescription drug coverage, but some plans may have certain requirements and limitations.
Other Common Questions
- Does Qulipta cause 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).
- Will taking Qulipta cause 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.
- Does Qulipta cause 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.