Migraines: new NHS treatment for 'debilitating' condition which dissolves under tongue

A treatment for acute migraines which dissolves under the tongue has been approved for NHS use, with experts saying it is a “step change” for thousands of people.

Rimegepant has been recommended for adults who cannot take other medicines or do not respond to them.

Health experts say around 13,000 people will benefit, and a migraine charity said it brought "new hope" for those suffering from the side effects.

The National Institute for Health and Care Excellence (Nice) said its final draft guidance on Rimegepant “addresses the high unmet need for treatment options for acute migraine”.

Side effects of migraines range from vomiting to light sensitivity and sight problems, and attacks can last for up to three days.

Around one in seven people are affected by migraines - they are more common in women than men, and mostly affect people aged 35 to 45.

Rimegepant, also known as Vydura and made by Pfizer, will be available to adults who have tried at least two triptans – medication usually given to tackle headaches or migraines – but found they did not work well enough.

It can also be administered to those who are not able to take triptans or have an intolerance, or patients who have tried nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol.

Helen Knight, director of medicines evaluation at Nice, said: “Migraine is a condition described in comments to Nice from carers and people with migraine as an invisible disability that affects all aspects of life including work, education, finances, mental health, social activities and family.

“Today’s final draft guidance addresses the high unmet need for treatment options for acute migraine, once again demonstrating our ability to ensure clinically and cost-effective medicines are available to those who need them as quickly as possible.”

Rimegepant is taken as a wafer, which dissolves under the tongue and works by stopping the release of a protein around the brain called calcitonin gene-related peptide.

In July, the medicine was recommended as an option for preventing episodic migraine in adults who have at least four and fewer than 15 attacks per month if “at least” three other treatments have not worked.

Under the latest guidance, it will also be used to relieve symptoms of a migraine, which can include pain, nausea and sensitivity to light, but also painless symptoms such as temporary visual disturbances known as “aura”, which Nice said “is not well managed with existing treatments”.

Ms Knight added: “This is the first and only Nice-recommended medicine that can help alleviate the misery of acute migraines, and may be considered a step change in treatment.”

Robert Music, chief executive of The Migraine Trust, said the Nice guidance “provides people with migraine valuable options to help reduce the pain and length of a migraine attack”.

“It brings new hope,” he added. “It will especially benefit those who have not found a treatment that works, those who get debilitating side effects – including medicine overuse headache – from them, and those with cardiovascular disease who cannot take existing treatments.

“Migraine is an incredibly misunderstood condition that can have a significant impact on all areas of life, including ability to work, maintain relationships and mental health.”