| Migraine Disorders
Nurtec ODT vs Botox
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Nurtec Odt vs Botox with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsBotox has a higher rate of injection site reactions vs Nurtec Odt based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Botox but not Nurtec Odt, including UnitedHealthcare
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Category
Nurtec Odt
Botox
At A Glance
Oral
As needed or every other day
CGRP receptor antagonist
IM injection
Every 12 weeks
Botulinum toxin type A
Indications
- Migraine Disorders
- Episodic migraine
- Overactive Bladder
- Migraine Disorders
- Benign essential blepharospasm
- Strabismus, Comitant
Dosing
Migraine Disorders 75 mg orally as needed; maximum 75 mg per 24-hour period; safety of more than 18 doses in a 30-day period has not been established; may be taken with or without food.
Episodic migraine 75 mg orally every other day, with or without food.
Overactive Bladder 100 Units injected as 0.5 mL (5 Units) across 20 sites into the detrusor via cystoscope; repeat no sooner than 12 weeks.
Detrusor Overactivity associated with a Neurologic Condition 200 Units injected as 1 mL (~6.7 Units) across 30 sites into the detrusor via cystoscope; repeat no sooner than 12 weeks.
Pediatric Detrusor Overactivity associated with a Neurologic Condition 200 Units (>=34 kg) or 6 Units/kg (<34 kg) via intradetrusor injection across 20 sites; repeat no sooner than 12 weeks.
Migraine Disorders 155 Units IM as 0.1 mL (5 Units) per site divided across 7 head/neck muscle areas; re-treat every 12 weeks.
Adult Upper Limb Spasticity 75-400 Units IM divided among affected muscles; re-treat no sooner than 12 weeks.
Adult Lower Limb Spasticity 300-400 Units IM divided across 5 muscles (gastrocnemius, soleus, tibialis posterior, flexor hallucis longus, flexor digitorum longus); re-treat no sooner than 12 weeks.
Pediatric Upper Limb Spasticity 3-6 Units/kg IM (maximum 200 Units) divided among affected muscles; re-treat no sooner than 12 weeks.
Pediatric Lower Limb Spasticity 4-8 Units/kg IM (maximum 300 Units) divided among affected muscles; re-treat no sooner than 12 weeks.
Cervical Dystonia Dose individualized based on head/neck position, pain, and muscle hypertrophy; mean dose approximately 236 Units IM divided among affected muscles.
Primary Axillary Hyperhidrosis 50 Units per axilla injected intradermally across 10-15 sites approximately 1-2 cm apart.
Benign essential blepharospasm 1.25-2.5 Units injected into 3 sites per affected eye; re-treat approximately every 3 months.
Strabismus, Comitant 1.25-5 Units per muscle via electromyographic-guided injection, dosed based on deviation size in prism diopters; re-examine 7-14 days after each injection.
Contraindications
- History of hypersensitivity reaction to rimegepant, NURTEC ODT, or any of its components, including anaphylaxis and delayed serious hypersensitivity
- Hypersensitivity to any botulinum toxin product or to any component of the formulation
- Infection at the proposed injection site(s)
- Urinary tract infection at time of intradetrusor injection
- Urinary retention or post-void residual urine volume >200 mL in patients not routinely performing clean intermittent self-catheterization (for intradetrusor injection)
Adverse Reactions
Most common Nausea, abdominal pain/dyspepsia
Serious Hypersensitivity including dyspnea and severe rash
Postmarketing Hypersensitivity (anaphylaxis), hypertension, Raynaud's phenomenon
Most common (>=2%) Urinary tract infection, dysuria, urinary retention, neck pain, headache, muscular weakness, eyelid ptosis, injection site pain, dysphagia, upper respiratory infection
Serious Spread of toxin effects, dysphagia and breathing difficulties, hypersensitivity reactions, autonomic dysreflexia, corneal exposure and ulceration, retrobulbar hemorrhage
Postmarketing Abdominal pain, alopecia, brachial plexopathy, peripheral neuropathy, arrhythmia, myocardial infarction, death associated with dysphagia and pneumonia, new onset or recurrent seizures
Pharmacology
Rimegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; it is an orally administered small molecule that blocks the CGRP receptor implicated in migraine pathophysiology, indicated for both acute and preventive treatment.
Botulinum toxin type A that blocks neuromuscular transmission by inhibiting acetylcholine release at motor and autonomic nerve terminals through cleavage of SNAP-25, producing localized, reversible chemical denervation of muscle, sweat glands, or the detrusor depending on injection site.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Nurtec Odt
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (12/12)
Botox
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (11/12) · Qty limit (0/12)
UnitedHealthcare
Nurtec Odt
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Botox
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Nurtec Odt
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Botox
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAccessia Health: Multiple Sclerosis - Private Insurance: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.