Rimegepant interactions

Food & lifestyle

• grapefruit juice

  Moderate

  Metabolism

  Coadministration with grapefruit or grapefruit juice may increase the plasma concentrations of rimegepant. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruit.

  What to do: Rimegepant may be administered with or without food. Until more information is available, patients receiving rimegepant may want to avoid the regular consumption of grapefruits and grapefruit juice to prevent undue increases in plasma levels and systemic effects of rimegepant. If grapefruit or grapefruit juice is consumed concomitantly with rimegepant, the manufacturer recommends avoiding another dose of rimegepant within 48 hours.

  1 source

  1. "Product Information. Nurtec ODT (rimegepant)." Biohaven Pharmaceuticals (2020):

Conditions

Conditions in which Rimegepant needs care, as documented in this source.

• Kidney Diseases

  Major

  Rimegepant should be avoided in patients with ESRD as it not been studied in patients with CrCl less than 15 mL/min or among patients on dialysis. No dosage adjustment is necessary for patients with mild to severe renal impairment. A single-dose pharmacokinetic study showed exposure to rimegepant in patients with mild or severe renal impairment was not clinically meaningful different compared to normal subjects, however, exposure in subjects with moderate renal impairment was approximately 40% higher. In healthy male subjects, 78% of a radiolabeled dose was excreted in the feces and 24% in the urine.

  1 source

  1. "Product Information. Nurtec ODT (rimegepant)." Biohaven Pharmaceuticals (2020):

• Liver Failure

  Major

  Rimegepant should be avoided in patients with severe hepatic impairment. A dedicated pharmacokinetic study has shown an approximately 2-fold increased exposure to a single-dose of rimegepant in patients with severe hepatic impairment (Child-Pugh class C). There were no clinically meaningful differences in rimegepant exposure with mild (Child-Pugh class A) and moderate hepatic impairment (Child-Pugh class B).

  1 source

  1. "Product Information. Nurtec ODT (rimegepant)." Biohaven Pharmaceuticals (2020):