Which of the following are oral CGRP antagonists used for migraine prevention?

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Multiple Choice

Which of the following are oral CGRP antagonists used for migraine prevention?

The main concept here is that some migraine-prevention drugs are oral small-molecule antagonists that block the CGRP pathway (called gepants). These are taken by mouth, in contrast to the monoclonal antibodies that target CGRP or its receptor and are given by injection. Rimegepant and atogepant are both gepants, meaning they block CGRP signaling at the receptor. By preventing CGRP from binding, they reduce the migraine-related vasodilation and nociceptive signaling, which helps lower the frequency of migraine attacks when used for prevention. That’s why this pair is the correct choice for an oral CGRP antagonist used for prevention. Sumatriptan and rizatriptan are triptans; they act on serotonin receptors to abort an ongoing migraine, not to prevent it. Fremanezumab and eptinezumab are monoclonal antibodies against CGRP or its receptor and are given by injection, not orally. Candasartan and propranolol are antihypertensives sometimes used for migraine prevention but do not target CGRP, so they’re not oral CGRP antagonists.

The main concept here is that some migraine-prevention drugs are oral small-molecule antagonists that block the CGRP pathway (called gepants). These are taken by mouth, in contrast to the monoclonal antibodies that target CGRP or its receptor and are given by injection.

Rimegepant and atogepant are both gepants, meaning they block CGRP signaling at the receptor. By preventing CGRP from binding, they reduce the migraine-related vasodilation and nociceptive signaling, which helps lower the frequency of migraine attacks when used for prevention. That’s why this pair is the correct choice for an oral CGRP antagonist used for prevention.

Sumatriptan and rizatriptan are triptans; they act on serotonin receptors to abort an ongoing migraine, not to prevent it. Fremanezumab and eptinezumab are monoclonal antibodies against CGRP or its receptor and are given by injection, not orally. Candasartan and propranolol are antihypertensives sometimes used for migraine prevention but do not target CGRP, so they’re not oral CGRP antagonists.

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