Can You Take Nurtec Twice A Day?

In our latest question and answer, our pharmacist answers a reader question about accidentally taking two doses of Nurtec in a 24-hour period.

Question

I took two 75 mg Nurtec only 17 hours apart. Do I need to be worried?

Asked by Nancy On Nov 06, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Nov 08, 2022
Last updated Apr 25, 2024

Key points

  • Data is limited, but accidentally taking an additional dose of Nurtec in a 24-hour period is unlikely to cause significant side effects.
  • Early clinical trials for Nurtec evaluated dosages up to 600mg per day, which were shown to be generally well tolerated.

Answer

Although Nurtec (rimegepant) is only FDA-approved for a maximum of one dose (75mg) per day, you likely are safe having accidentally taken two doses separated by only 17 hours (i.e., two doses in a 24-hour period).

You may be slightly more at risk for some mild side effects, such as nausea, dizziness, diarrhea, etc..., but the data we have available to us indicates there is no serious risk of toxicity at the dose you took.

Safety Of Nurtec At Higher Doses

While we don't have extensive data on daily doses above 75mg, clinical trials for the drug, prior to it being approved, evaluated the drug at a range of dosages, including:

  • 10mg per day
  • 25mg per day
  • 75mg per day
  • 150mg per day
  • 300mg per day
  • 600mg per day

One such trial that evaluated these dosages can be found here (please note that this study refers to Nurtec as BMS-927711).

This trial found that the safety of Nurtec at 75mg and 150mg per day was essentially the same, with the 150mg group only experiencing slightly more nausea.

One of the main reasons why Nurtec is only available up to 75mg per day is that clinical trials didn't find that higher doses were more effective. For example, the study I noted above stated the following:

Among the BMS-927711 [NURTEC] dose groups, the percentage of subjects who were pain free at two hours post-dose was 32.9% (28/85) in the 150 mg; 31.4% (27/86) in the 75 mg; and 29.7% (33/111) in the 300 mg dose, compared to 15.3% of patients in the placebo group. No additional benefit was seen with the 600 mg dose (24.4%, 20/82).
Cephalalgia . 2014 Feb;34(2):114-25.

The study went on to say that all of the dosages evaluated only produced mild to moderate side effects in a small number of individuals.

What Is The Recommended Dosing For Nurtec?

Since we're on the subject of dosing, I just wanted to add here what the FDA-approved dosing for the drug is:

  • Acute Migraine Treatment: Nurtec 75 mg by mouth as a single dose. Max: 75 mg/day. The safety of using more than 18 doses in a 30-day period has not been established.
  • Episodic Migraine Prophylaxis: Nurtec 75 mg by mouth every other day.

Final Words

I hope this answer helped!

Although data is limited, you can feel assured that you likely are at only a slightly increased risk of mild side effects having taken two Nurtec tablets. Far greater dosages have been evaluated and have appeared to be relatively safe.

However, be sure to try and stick to taking the drug how your doctor has prescribed it for you.

A good resource to keep in mind if you ever find yourself in a situation where you have accidentally taken two doses of a drug is the Poison Control Centers website (Poison.org). They can also be reached at 1-800-222-1222.

Thanks for reaching out!

References

  • BMS-927711 for the acute treatment of migraine: a double-blind, randomized, placebo controlled, dose-ranging trial, PubMed
  • Nurtec Prescribing Information, AccessFDA

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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