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.
I took two 75 mg Nurtec only 17 hours apart. Do I need to be worried?
Nov 06, 2022- Nurtec is FDA-approved for a maximum of one 75mg dose per day, though accidentally taking two doses in a 24-hour period is generally considered safe with only a mild risk of side effects like nausea or dizziness.
- Higher doses of Nurtec up to 150mg per day were tested in clinical trials and found to be safe, but they did not provide additional benefit for treating migraines compared to the approved 75mg dose.
- You should take Nurtec only as prescribed by your doctor, and contact Poison Control at 1-800-222-1222 if you have concerns about accidental overdose.
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).
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 & sources
Glossary — Terms in This Answer
- FDA-approved
- Officially authorized by the Food and Drug Administration, the U.S. government agency that regulates medications.
- Toxicity
- The quality of being poisonous or harmful to the body at a given dose.
- Clinical trials
- Research studies conducted on human subjects to test whether a drug is safe and effective.
- Dosages
- Specific amounts of a medication given at one time or over a period of time.
- Placebo
- An inactive substance given to a control group in a study to compare against the actual medication being tested.
- Acute migraine treatment
- Medication taken immediately when a migraine headache occurs to relieve symptoms.
- Episodic migraine prophylaxis
- Regular preventive medication taken to reduce the frequency of occasional migraine headaches.
- Rimegepant
- The generic chemical name for the medication sold under the brand name Nurtec.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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