Pharmacology recent Update
GEPANTS :: For Acute Migraine management…( Very high yield topic)
GEPANTS are small molecules that block the CGRP docking station or CGRP receptor and do not cause blood vessels to narrow ( unlike triptans which causes vasoconstriction )…so patients with acute migraine has minimal side-effects with GEPANTS when compared with triptans…
GEPANTS metabolize by CYP3A4 enzyme…
There are 4 GEPANTS which are FDA approved / to be approved
UBROGEPANT and RIMEGEPANT are FDA approved for Acute migraine management…
RIMEGEPANT is only drug which is being FDA approved for Acute migraine and also being Studied for Preventive Migraine therapy…
ATOGEPANT is being studied Exclusively for Prevention therapy of Migraine…
VAZEGEPANT…It’s Nasal spray… Being studied for acute prevention of migraine…In trials it is showing positive results…
UBROGEPANT , RIMEGEPANT , ATOGEPANT are oral drugs used in Migraine management… .
Side effect profile of GEPANTS::
Very minimal side-effects like nausea , fatigue, UTIs ( with RIMEGEPANT ) , Constipation ( with ATOGEPANT)…
Remember All these GEPANTS are second generation molecules…First generation GEPANTS are having significant LIVER TOXICITY…so they are abandoned…