Ubrelvy dosage, forms, and strengths

Ubrelvy is a brand-name prescription medication used to treat migraines with or without visual aura. Its active ingredient, ubrogepant, belongs to a family of drugs called calcitonin gene-related peptide receptor antagonists, or CGRP inhibitors. These drugs block a small molecule (CGRP) produced in great quantities at the beginning of a migraine attack. Their presence causes blood vessels to constrict rapidly, producing headache pain and many of the symptoms of a migraine. The U.S. Food and Drug Administration (FDA) has approved Ubrelvy to treat an acute migraine, not to prevent it. Doctors often prescribe other CGRP inhibitors to prevent migraines. People take a Ubrelvy tablet only when they experience a migraine headache. If that initial dose doesn’t work or the pain returns, a second dose can be taken between two to 48 hours later.

Ubrelvy forms and strengths

Ubrelvy has only one dosage form: oral tablets. It is available in two dosage strengths:

• Tablets: 50 milligrams (mg), 100 mg

Ubrelvy dosage for adults

The FDA has approved Ubrelvy as an as-needed treatment to reduce or eliminate migraine headache pain as well as other migraine symptoms of nausea and sensitivity to light or sound. Take Ubrevly any time during a migraine attack. The initial dose usually reduces or eliminates migraine pain within two hours. If that doesn’t work, a second dose can be taken two to 48 hours after the first. You can take Ubrelvy tablets with a meal or on an empty stomach. However, taking Ubrelvy with food delays the absorption of the drug. Avoid aking Ubrelvy with a high-fat meal as this delays absorption and decreases its effectiveness.

Ubrelvy dosage for children

Ubrelvy has not been FDA approved for use in children or teens.

Ubrelvy dosage restrictions

Ubrelvy is given at the lowest possible dose to some people based on their kidney health, liver health, or other drugs they may be taking. In some cases, medical conditions or other drugs make Ubrelvy unsafe to take at all. The liver breaks down ubrogepant. Some medications interfere with that process. Ask your pharmacist if your medications interact with eachother. People taking these drugs or who have liver problems may require a dose adjustment. Additionally, the kidneys eliminate some medicines, so kidney problems may also cause hazards when taking Ubrelvy. If you have not had a recent comprehensive metabolic panel, ask your physician to confirm that the dose of Ubrelvy is right for you.

• Severe renal impairment (creatinine clearance 15-29 mL/min): 50 mg for both the initial dose and second dose 

• End-stage renal disease (creatinine clearance < 15 mL/min): Avoid Ubrelvy use

• Severe hepatic impairment (Child-Pugh Class C): 50 mg for both the initial dose and second dose

How to take Ubrelvy

Ubrelvy is taken on an as-needed basis for migraine treatment. The FDA recommends that it not be used for more than eight migraines per month, so a monthly prescription may only have enough tablets to treat eight migraines. 

• Before taking Ubrelvy, read the prescription label, information leaflet, and Medication Guide. Ask your healthcare provider or pharmacist with any questions. 

• The prescription bottle will read how much medicine to use. Use as directed.

• Take an Ubrelvy tablet only when you have a migraine. This medicine is not used on a regular schedule and is not used to prevent migraine attacks.

• If your headache returns or you do not have complete relief after the first pill, wait at least 2 hours before taking another tablet. 

• Do not take more than two doses in 24 hours. Call your healthcare provider if you need to use the medicine more than two times in 24 hours.

• You can take Ubrelvy with or without food. Avoid high-fat foods, grapefruit products, and grapefruit juice while taking Ubrelvy.

• You should not take a second dose of Ubrelvy within 24 hours if you have consumed grapefruit, grapefruit juice or if you take ciprofloxacin,  cyclosporine,  fluconazole,  fluvoxamine, or verapamil.

• Do not use Ubrelvy to treat more than eight migraines per month. If migraines are more frequent than that, talk to the prescribing healthcare provider about starting a different medication to take daily to help decrease the number of migraines

• Store the medicine at room temperature. Keep out of reach and out of sight of children and pets.

Ubrelvy dosage FAQs

How long does it take Ubrelvy to work?

Ubrelvy is intended to eliminate or reduce migraine pain and other symptoms within two hours of taking a dose. Some people will have pain relief in one hour. In clinical studies, about 60% of participants experienced pain relief, and 20% were pain-free in two hours, significantly higher than participants given a placebo. In some participants, the pain returned in the first 24 hours. If so, a second dose can be taken two to 48 hours after the first unless you have a contraindication to a second dose.

How long does Ubrelvy stay in your system?

The active ingredient in Ubrelvy has a half-life of five to seven hours. The drug should fall to undetectable levels in a day. That doesn’t mean it works all day long. In clinical trials, only about 13% to 15% of participants experienced pain freedom for up to eight hours after taking a dose. It may be necessary to take a second dose even when the first dose does not completely rid the pain.

What happens if I miss a dose of Ubrelvy?

Ubrelvy is taken on an as-needed basis. There isn’t such a thing as a missed dose of Ubrelvy.

You can take the initial dose of Ubrelvy at any time during a migraine headache. There is no optimal time to take the drug. In clinical trials, participants started taking Ubrelvy at any time from the start of migraine pain to four hours later. Delays did not affect results. 

The second dose can be taken at any time two hours or more after the first pill. If the second dose is missed and headache pain is still a problem, take the dose when you can.

How long can you take Ubrelvy?

Ubrelvy has no upper time limit. People can take the drug for as long as it works and minimizes side effects. However, you should not use Ubrelvy more than eight times per month to treat active migraines as this would signal a high migraine burden that may benefit from daily medicine to stop migraine formation.

How do I stop taking Ubrelvy?

You can stop Ubrelvy at any point without experiencing withdrawal symptoms. Ubrelvy is only taken as an acute treatment for migraine. It is not a preventive medicine, so stopping Ubrelvy will not increase the likelihood of a migraine attack.

What is the maximum dosage for Ubrelvy?

The prescribed dosage is the maximum dosage. Stay within the prescribed dose or take up to two doses in 24 hours. The FDA has determined that 200 mg daily is the maximum dose, but only for people prescribed 100 mg tablets. If you are prescribed 50 mg tablets, the maximum daily dosage is 100 mg. You may be on the lower dose for safety reasons. If that recommended dose is not working, talk to the prescriber.

Can you overdose on Ubrelvy?

There are no reported adverse effects of an Ubrelvy overdose, though people who take too much Ubrelvy should contact a doctor or go to an emergency room. 

It is essential to understand all the restrictions on taking Ubrelvy. There are three ways to overdose on Ubrelvy: 

• Taking too many tablets at once

• Taking more than two tablets in 24 hours

• Using Ubrelvy to treat more than eight migraines per month

If you take too many tablets at once or too many in one day, call a poison helpline or go to an emergency room. If you need to take more than two tablets in 24 hours, call the doctor for medical advice. 

To avoid taking Ubrelvy too many times a month, the manufacturer suggests keeping a diary of the times you take Ubrelvy and how much you take. If you need to use Ubrelvy as a migraine treatment more than eight times per month, talk to the prescriber about alternatives. 

What interacts with Ubrelvy?

Ubrelvy has several drug interactions that can be serious. Some drugs can never be taken with Ubrelvy.

The most concerning drug interactions involve drugs that slow down the body’s ability to metabolize ubrogepant. These drugs are called CYP3A4 inhibitors. CYP3A4 is the primary liver enzyme that breaks down ubrogepant. 

Some drugs shut down this process so well they can never be taken with Ubrelvy. The list is very long and includes the antibiotic clarithromycin, the antifungal drugs ketoconazole and itraconazole, and the antiviral medication ritonavir (one of the ingredients in the COVID-19 drug Paxlovid). If you are infected with COVID-19 and your provider prescribes Paxlovid, tell the prescriber about Ubrelvy.

You can take a single dose of Ubrelvy some of these drugs, but you are not allowed a second dose. These include:

• Grapefruit

• Grapefruit juice

• The blood pressure medication verapamil

• The antifungal drug fluconazole

• The OCD medication fluvoxamine

• The antibiotic ciprofloxacin

• The immunosuppressant cyclosporine

Other similar drugs allow the maximum Ubrelvy dose of 50 mg. Pharmacists are very familiar with these drugs and should alert the patient of a potentially hazardous drug interaction.

Other liver enzyme blockers called BCRP or P-gp inhibitors may also cause problems. 

However, healthcare providers will not advise patients to adjust dosages.

Some drugs called strong CYP3A4 inducers speed up the liver’s breakdown of ubrogepant. These include the anticonvulsant phenytoin, the antibiotic rifampin, and the over-the-counter supplement St. John’s wort. They reduce Ubrelvy’s effectiveness at fighting migraines. The prescriber may need to maximize the Ubrelvy dose.

Can other migraine medications be taken with Ubrelvy?

There are no restrictions on the concomitant use of other migraine medications like sumatriptan. However, this applies equally to acute treatments of migraine and preventive treatments. However, healthcare professionals do not prescribe Ubrelvy to people taking other CGRP inhibitors for migraine prevention or treatment.

What happens when you mix Ubrelvy and alcohol?

The FDA does not warn about any drug interaction between Ubrelvy and alcohol. However, somnolence is one possible side effect of Ubrelvy so drinking may worsen any sleepiness or inattentiveness caused by the drug. Beware of using equipment or driving if you feel sleepy.

Is it safe to take Ubrelvy during pregnancy?

Prescribers can prescribe Ubrelvy to pregnant women after discussing the risks and benefits of this medication. Animal studies have shown that high doses of ubrogepant can cause birth defects. There is no evidence that normal clinical doses cause problems in humans. 

Is it safe to take Ubrelvy while breastfeeding?

Prescribers can prescribe Ubrelvy to breastfeeding women after discussing the risks and benefits of this medication while breastfeeding. However, there are no studies about whether ubrogepant is present in human breast milk, affects lactation, or has adverse effects on a nursing infant. 

What are the side effects of Ubrelvy?

Ubrelvy has very few side effects. The most common side effects are somnolence, dry mouth, and nausea. These affect one or two percent of people taking Ubrelvy. The most severe adverse reactions are allergic reactions, including hives, itching, angioedema (swelling of the skin around the mouth or throat), and anaphylaxis (a life-threatening allergic reaction). Any history of allergic reactions to Ubrelvy is an absolute contraindication and Ubrelvy will not be prescribed.

Sources

• How Ubrelvy works, AbbVie

• Ubrelvy, AbbVie

• Ubrelvy prescribing information, DailyMed, National Library of Medicine