Atogepant
CGRP antagonists (gepants and anti-CGRP antibodies)
CGRP antagonists (gepants and anti-CGRP antibodies)
An oral CGRP receptor blocker taken every day to prevent migraine. It does not treat an attack that has already started.
Quick facts
- Group
- CGRP antagonists (gepants and anti-CGRP antibodies)
- Target
- CGRP receptor (calcitonin receptor-like receptor, CALCRL, with RAMP1)
- Used for
- Prevention of migraine in adults
- Key effects
- Nausea · Constipation · Decreased appetite
- Monitor
- Blood pressure at follow-up
- ATC
- N02CD07
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows telcagepant, an earlier gepant that was never marketed, bound to the extracellular domains of the human CGRP receptor (CLR with RAMP1), where small-molecule gepants block the receptor; there is no structure with this drug.
Atogepant is a small-molecule antagonist of the CGRP receptor (a gepant). Calcitonin gene-related peptide (CGRP), released by trigeminal nerves during migraine, dilates meningeal vessels and drives neurogenic inflammation. Gepants bind at the junction of the two receptor subunits (CLR and RAMP1) and stop CGRP from activating it. Unlike triptans, they do not constrict blood vessels.
- Atogepant blocks the CGRP receptor every day
- Trigeminal CGRP signalling stays damped
- Fewer migraine days over time
Indications
- Prevention of migraine in adults Migraine →
Adverse effects
Common
- Nausea
- Constipation
- Decreased appetite
- Tiredness and sleepiness
Contraindications
- Hypersensitivity to atogepant or any component of the product
Key interactions
- St John's wort
- Can lower atogepant levels
- Grapefruit and grapefruit juice
- Their use is discussed with the treating team
- Acute migraine medicines
- Still needed for attacks: atogepant only prevents them
What is monitored
- Blood pressure at follow-up
- Fingers and toes for Raynaud symptoms
- Headache diary to judge the benefit
Administration and safety
- Oral tablet once a day at about the same time
- Not stopped without talking to the treating team
Pregnancy and breastfeeding
There is little information in pregnancy; it is a decision for the treating team.
Nursing care
- Measure blood pressure before starting and at visits
- Ask about Raynaud phenomenon, kidney and liver disease
- Teach the warning signs of high blood pressure: severe headache, chest pain, vision changes
Pharmacokinetics
- Absorption
- Oral tablet once a day, with or without food
Test yourself
Think of the answer, then tap the question to see it.
Is atogepant used to treat a migraine attack in progress?
No; it is a daily preventive medicine.
Which two vascular problems are watched for with atogepant?
High blood pressure and Raynaud phenomenon.
Which receptor does atogepant block?
The CGRP receptor (CLR with RAMP1).
Connections
← Back to the class: CGRP antagonists (gepants and anti-CGRP antibodies)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Atogepant: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); RCSB PDB - 3N7R: Crystal structure of the ectodomain complex of the CGRP receptor, a Class-B GPCR, reveals the site of drug antagonism (RCSB Protein Data Bank, 2026).
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Representative model, for educational purposes only.