Emgality and Nurtec Comparison

Emgality®(galcanezumab-gnlm)	Nurtec®(rimegepant)
Prescription Only Emgality is a medication that can be self-administered once a month by injecting it subcutaneously under the skin. It is used for migraine prevention in adults and can also be...	Prescription Only Nurtec ODT is a medication that can be placed under or onto the tongue to treat migraine symptoms in adults. When taken every other day, it can also be used to prevent episodic...
Administration
Subcutaneous. Learn more.	Oral . Learn more.
Dosing
Migraine: 240 mg loading dose (120 mg x 2) followed by 120 mg monthly. . Learn more.	Acute treatment of migraine: 75 mg as needed. Preventive treatment of episodic migraine: 75 mg every other day. Maximum daily dose: 75 mg.. Learn more.
Latin Shorthand
240 mg LD (120 mg x 2) then 120 mg/mo.. Learn more.	Acute treatment of Migraine: 75 mg PRN. Preventive treatment of Episodic Migraine: 75 mg qod.. Learn more.
Out-Of-Pocket Costs With Copay Card
$0. Learn more.	$0. Learn more.
Annual Cap
$4900. Learn more.	Learn more.
Assistance Expiration
12 months. Learn more.	Learn more.
Generics
No lower-cost generic available	No lower-cost generic available
Adverse Reactions
The most common adverse reactions (incidence ≥2% and at least 2% greater than placebo) in EMGALITY clinical studies were injection site reactions. . Learn more.	Acute treatment of migraine: the adverse reaction reported in ≥ 1% of patients treated with NURTEC ODT is nausea. Preventive treatment of episodic migraine: adverse reactions reported in ≥ 2% for rimegepant and ≥ 1% higher than placebo are nausea and abdominal pain/dyspepsia.. Learn more.
Mechanism of Actions (MoA)
CGRP Antagonist. Learn more.	CGRP Antagonist. Learn more.
Special Populations
What is the Pregnancy Exposure Registry for EMGALITY? The Pregnancy Exposure Registry is a program that monitors pregnancy outcomes in women who have been exposed to EMGALITY during pregnancy. It is designed to collect information on any potential risks to the developing fetus. How can pregnant women enroll in the Pregnancy Exposure Registry? Pregnant women can enroll in the registry by calling 1-833-464-4724 or by contacting the company at www.migrainepregnancyregistry.com. What is the estimated risk of major birth defects and miscarriage in the general population and among women with migraine? The estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2%-4% and 15%-20%, respectively, in the general population. The estimated rate of major birth defects (2.2%-2.9%) and miscarriage (17%) among deliveries to women with migraine are similar to rates reported in women without migraine. Are there any known risks associated with the use of EMGALITY during pregnancy? There are no adequate data on the developmental risk associated with the use of EMGALITY in pregnant women. However, animal studies have shown that administration of galcanezumab-gnlm to rats and rabbits during the period of organogenesis or to rats throughout pregnancy and lactation at plasma exposures greater than that expected clinically did not result in adverse effects on development. Can EMGALITY be used during lactation? There are no data on the presence of galcanezumab-gnlm in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for EMGALITY and any potential adverse effects on the breastfed infant from EMGALITY or from the underlying maternal condition. Is EMGALITY safe for pediatric use? Safety and effectiveness in pediatric patients have not been established. Is there any difference in the response to EMGALITY in geriatric patients compared to younger patients? Clinical studies of EMGALITY did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients.	Is NURTEC ODT safe to use during pregnancy? There are no adequate data on the developmental risk associated with the use of NURTEC ODT in pregnant women. In animal studies, oral administration of rimegepant during organogenesis resulted in adverse effects on development in rats (decreased fetal body weight and increased incidence of skeletal variations) at exposures greater than those used clinically and which were associated with maternal toxicity. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. The estimated rate of major birth defects (2.2 to 2.9%) and miscarriage (17%) among deliveries to women with migraine are similar to rates reported in women without migraine. Women exposed to NURTEC ODT during pregnancy can participate in a pregnancy exposure registry that monitors pregnancy outcomes. Healthcare providers or patients can contact 1-877-366-0324, email nurtecpregnancyregistry@ppd.com, or visit nurtecpregnancyregistry.com for more information. Can I take NURTEC ODT while breastfeeding? A lactation study conducted on 12 healthy adult lactating women who were between 2 weeks and 6 months postpartum and were administered a single oral dose of rimegepant 75 mg established a relative infant dose of less than 1% of the maternal weight-adjusted dose and a milk-to-plasma ratio of 0.20. These data support that transfer of rimegepant into breastmilk is low. However, there are no data on the effects of rimegepant on a breastfed infant or on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for NURTEC ODT and any potential adverse effects on the breastfed infant from NURTEC ODT or from the underlying maternal condition. Is NURTEC ODT safe for use in children? Safety and effectiveness in pediatric patients have not been established for NURTEC ODT. Is NURTEC ODT safe for use in elderly patients? In pharmacokinetic studies, no clinically significant pharmacokinetic differences were observed between elderly and younger subjects. However, clinical studies of NURTEC ODT did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Do patients with renal impairment need a dosage adjustment of NURTEC ODT? No, dosage adjustment is not required in patients with mild, moderate, or severe renal impairment. However, NURTEC ODT has not been studied in patients with end-stage renal disease and in patients on dialysis. It is advised to avoid the use of NURTEC ODT in patients with end-stage renal disease (CLcr < 15 mL/min). What is the recommended dose of NURTEC ODT for patients with severe renal impairment? The recommended dosage of NURTEC ODT for patients with severe renal impairment (CLcr 15-29 mL/min) is the same as for patients with normal renal function, which is a single dose of 75 mg. However, NURTEC ODT has not been studied in patients with end-stage renal disease and in patients on dialysis. It is advised to avoid the use of NURTEC ODT in patients with end-stage renal disease (CLcr < 15 mL/min). Can patients on dialysis use NURTEC ODT? NURTEC ODT has not been studied in patients on dialysis. It is advised to avoid the use of NURTEC ODT in patients with end-stage renal disease (CLcr < 15 mL/min).

Emgality®(galcanezumab-gnlm)

Nurtec®(rimegepant)

Prescription Only

Emgality is a medication that can be self-administered once a month by injecting it subcutaneously under the skin. It is used for migraine prevention in adults and can also be...

Prescription Only

Nurtec ODT is a medication that can be placed under or onto the tongue to treat migraine symptoms in adults. When taken every other day, it can also be used to prevent episodic...

Dosage & Administration

Administration

Subcutaneous. Learn more.

Oral . Learn more.

Dosing

Migraine: 240 mg loading dose (120 mg x 2) followed by 120 mg monthly. . Learn more.

Acute treatment of migraine: 75 mg as needed. Preventive treatment of episodic migraine: 75 mg every other day. Maximum daily dose: 75 mg.. Learn more.

Latin Shorthand

240 mg LD (120 mg x 2) then 120 mg/mo.. Learn more.

Acute treatment of Migraine: 75 mg PRN. Preventive treatment of Episodic Migraine: 75 mg qod.. Learn more.

Financial Assistance

Out-Of-Pocket Costs With Copay Card

$0. Learn more.

Annual Cap

$4900. Learn more.

Learn more.

Assistance Expiration

12 months. Learn more.

Learn more.

Generics

No lower-cost generic available

Physician Advisory

Adverse Reactions

The most common adverse reactions (incidence ≥2% and at least 2% greater than placebo) in EMGALITY clinical studies were injection site reactions. . Learn more.

Acute treatment of migraine: the adverse reaction reported in ≥ 1% of patients treated with NURTEC ODT is nausea. Preventive treatment of episodic migraine: adverse reactions reported in ≥ 2% for rimegepant and ≥ 1% higher than placebo are nausea and abdominal pain/dyspepsia.. Learn more.

Mechanism of Actions (MoA)

CGRP Antagonist. Learn more.

Special Populations

What is the Pregnancy Exposure Registry for EMGALITY?

The Pregnancy Exposure Registry is a program that monitors pregnancy outcomes in women who have been exposed to EMGALITY during pregnancy. It is designed to collect information on any potential risks to the developing fetus.

How can pregnant women enroll in the Pregnancy Exposure Registry?

Pregnant women can enroll in the registry by calling 1-833-464-4724 or by contacting the company at www.migrainepregnancyregistry.com.

What is the estimated risk of major birth defects and miscarriage in the general population and among women with migraine?

The estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2%-4% and 15%-20%, respectively, in the general population. The estimated rate of major birth defects (2.2%-2.9%) and miscarriage (17%) among deliveries to women with migraine are similar to rates reported in women without migraine.

Are there any known risks associated with the use of EMGALITY during pregnancy?

There are no adequate data on the developmental risk associated with the use of EMGALITY in pregnant women. However, animal studies have shown that administration of galcanezumab-gnlm to rats and rabbits during the period of organogenesis or to rats throughout pregnancy and lactation at plasma exposures greater than that expected clinically did not result in adverse effects on development.

Can EMGALITY be used during lactation?

There are no data on the presence of galcanezumab-gnlm in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for EMGALITY and any potential adverse effects on the breastfed infant from EMGALITY or from the underlying maternal condition.

Is EMGALITY safe for pediatric use?

Safety and effectiveness in pediatric patients have not been established.

Is there any difference in the response to EMGALITY in geriatric patients compared to younger patients?

Clinical studies of EMGALITY did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients.

Is NURTEC ODT safe to use during pregnancy?

There are no adequate data on the developmental risk associated with the use of NURTEC ODT in pregnant women. In animal studies, oral administration of rimegepant during organogenesis resulted in adverse effects on development in rats (decreased fetal body weight and increased incidence of skeletal variations) at exposures greater than those used clinically and which were associated with maternal toxicity. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. The estimated rate of major birth defects (2.2 to 2.9%) and miscarriage (17%) among deliveries to women with migraine are similar to rates reported in women without migraine. Women exposed to NURTEC ODT during pregnancy can participate in a pregnancy exposure registry that monitors pregnancy outcomes. Healthcare providers or patients can contact 1-877-366-0324, email nurtecpregnancyregistry@ppd.com, or visit nurtecpregnancyregistry.com for more information.

Can I take NURTEC ODT while breastfeeding?

A lactation study conducted on 12 healthy adult lactating women who were between 2 weeks and 6 months postpartum and were administered a single oral dose of rimegepant 75 mg established a relative infant dose of less than 1% of the maternal weight-adjusted dose and a milk-to-plasma ratio of 0.20. These data support that transfer of rimegepant into breastmilk is low. However, there are no data on the effects of rimegepant on a breastfed infant or on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for NURTEC ODT and any potential adverse effects on the breastfed infant from NURTEC ODT or from the underlying maternal condition.

Is NURTEC ODT safe for use in children?

Safety and effectiveness in pediatric patients have not been established for NURTEC ODT.

Is NURTEC ODT safe for use in elderly patients?

In pharmacokinetic studies, no clinically significant pharmacokinetic differences were observed between elderly and younger subjects. However, clinical studies of NURTEC ODT did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Do patients with renal impairment need a dosage adjustment of NURTEC ODT?

No, dosage adjustment is not required in patients with mild, moderate, or severe renal impairment. However, NURTEC ODT has not been studied in patients with end-stage renal disease and in patients on dialysis. It is advised to avoid the use of NURTEC ODT in patients with end-stage renal disease (CLcr < 15 mL/min).

What is the recommended dose of NURTEC ODT for patients with severe renal impairment?

The recommended dosage of NURTEC ODT for patients with severe renal impairment (CLcr 15-29 mL/min) is the same as for patients with normal renal function, which is a single dose of 75 mg. However, NURTEC ODT has not been studied in patients with end-stage renal disease and in patients on dialysis. It is advised to avoid the use of NURTEC ODT in patients with end-stage renal disease (CLcr < 15 mL/min).

Can patients on dialysis use NURTEC ODT?

NURTEC ODT has not been studied in patients on dialysis. It is advised to avoid the use of NURTEC ODT in patients with end-stage renal disease (CLcr < 15 mL/min).

Emgality® Alternatives