Since January it’s possible to get the new migraine tablets rimegepant (Vydura) on NHS prescription. As described in my previous post, this is a new type of pain killer, that can be used similarly to triptans but have a slower onset, less side effects, and don’t seem to cause medication overuse headache. In Dorset, this can be prescribed by any GP under certain restrictions:
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- It can be prescribed to a patient who cannot take a triptan – e.g. if they have angina, or have had a stroke, TIA or heart attack.
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- IT can be prescribed to a patient who have tried at least two types of triptans and either can’t tolerate the side effects or didn’t have any pain relief.
A GP should for now only prescribe at most eight tablets a month. More than that can be prescribed through neurology in selected cases – typically patients who have already anti-CGRP treatment. We’re still waiting for another medication – atogepant – which will hopefully be approved in a few months. Once this arrives, it might lead to more patients taking a gepant regularly as a preventative.
I have a few patients on a waitlist for rimegepant. If you’ve been told that you’re on it, expect to hear from me within the next couple of months.