Nurtec ODT is a 75 mg orally disintegrating tablet that you place on or under your tongue, where it dissolves without water. The same dose is used whether you’re treating an active migraine or taking it on a schedule to prevent them, but the frequency differs. Here’s everything you need to know to take it correctly.
How to Handle and Take the Tablet
Nurtec comes in individual foil blister packs, and the tablet is fragile enough that handling matters. Make sure your hands are dry before you open the pack. Peel back the foil covering rather than pushing the tablet through it, which can crumble or damage it. Place the tablet on your tongue or under your tongue immediately after opening. It dissolves in your saliva within seconds, so you don’t need water or any other liquid to swallow it.
Don’t remove the tablet from its blister pack ahead of time. It’s not designed to be stored loose in a pill organizer or pocket. The blister pack itself should stay inside the outer aluminum pouch until you’re ready to use it. Store everything at room temperature, between 68°F and 77°F.
Dosing for Acute Migraine Treatment
For an active migraine, take one 75 mg tablet as needed. You’re limited to one dose (75 mg) in any 24-hour period. In clinical trials, about 37% of patients experienced pain relief within one hour of taking it, so give it time to work before assuming it hasn’t helped.
The safety of taking more than 18 doses in a 30-day period has not been established, so keep a rough count if you’re using it frequently. If you’re reaching for Nurtec that often, it’s worth discussing a preventive approach with your prescriber.
Dosing for Migraine Prevention
When used preventively, you take one 75 mg tablet every other day on a consistent schedule. If you miss a dose, take it as soon as you remember. But if it’s already close to the time for your next scheduled dose, skip the missed one and pick up your regular schedule. Don’t double up to make up for a missed dose.
Food Affects How Well It Works
Taking Nurtec shortly after a high-fat meal can reduce how much of the drug your body absorbs by roughly a third, with peak levels dropping by as much as half. For the strongest effect, especially when treating an active migraine, try to take it on an empty stomach or at least avoid heavy, fatty foods in the 30 minutes before your dose. For every-other-day preventive use, this is less critical since the drug builds a consistent presence over time, but it’s still worth keeping in mind.
How Nurtec Works
During a migraine, a signaling molecule called CGRP floods certain nerve pathways, triggering pain, inflammation, and sensitivity. Nurtec blocks the receptors that CGRP binds to, effectively cutting off that pain signal. It works at two related receptor types, though it’s roughly 17 to 30 times more potent at the primary one. This dual blocking action may partly explain why it’s effective both for stopping a migraine in progress and for reducing their frequency when taken regularly.
Drug and Supplement Interactions
Nurtec is broken down by a specific liver enzyme, and anything that interferes with that enzyme changes how much of the drug ends up in your system. This matters in two directions.
Some substances slow the breakdown of Nurtec, causing it to build up to higher-than-intended levels. Strong inhibitors of this enzyme, including certain antifungals like itraconazole, the antibiotic clarithromycin, and the HIV medication ritonavir, should not be taken with Nurtec at all. In testing, itraconazole quadrupled the amount of Nurtec in the bloodstream. Moderate inhibitors like the blood pressure drug diltiazem, the antibiotic erythromycin, and the antifungal fluconazole require extra caution. If you take any of these, you should wait at least 48 hours before taking another dose of Nurtec. Grapefruit juice also falls into this category.
Other substances speed up the breakdown, making Nurtec less effective. The herbal supplement St. John’s wort is a common culprit. The tuberculosis drug rifampin reduced Nurtec levels by 80% in testing, essentially making it useless. This accelerated breakdown can linger for up to two weeks after you stop taking the interfering medication.
You should also avoid combining Nurtec with other CGRP-blocking medications. In clinical studies of similar drugs used together, constipation increased significantly.
Who Should Avoid Nurtec
Nurtec is contraindicated if you’ve ever had an allergic reaction to it, including delayed hypersensitivity reactions that can show up hours or days after a dose. People with severe liver impairment should avoid it because the drug reaches significantly higher concentrations in their blood. The same applies to people with end-stage kidney disease or those on dialysis, as Nurtec hasn’t been studied in that population.