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atogepant

Sold as Qulipta. Class: Calcitonin gene-related peptide (CGRP) antagonists. First FDA approval 09/28/2021: 5 years on the US market.

This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.

C

Score breakdown (70/100)

Safety ×35%
B
Evidence ×25%
F
Regulatory ×15%
B
Money & lawsuits ×15%
C
Options ×10%
C

Safety: 85

Evidence: 42

Regulatory history: 81

Money & lawsuits: 70

Options: 70

What the FDA label says

Approved uses

is indicated for the preventive treatment of migraine in adults. QULIPTA is a calcitonin gene-related peptide receptor antagonist indicated for the preventive treatment of migraine in adults. ( 1 )

Contraindications

is contraindicated in patients with a history of hypersensitivity to atogepant or any of the components of QULIPTA. Reactions have included anaphylaxis and dyspnea [see Warnings and Precautions ( 5.1 )] . Patients with a history of hypersensitivity to atogepant or to any of the components of QULIPTA. ( 4 )

Warnings and precautions

Hypersensitivity Reactions: If a hypersensitivity reaction occurs, discontinue QULIPTA and initiate appropriate therapy. Severe hypersensitivity reactions have included anaphylaxis and dyspnea. These reactions can occur days after administration. ( 5.1 ) Hypertension: New-onset or worsening of pre-existing hypertension may occur. ( 5.2 ) Raynaud’s phenomenon: New-onset or worsening of pre-existing Raynaud’s phenomenon may occur. ( 5.3 ) 5.1 Hypersensitivity Reactions Hypersensitivity reactions, including anaphylaxis, dyspnea, rash, pruritus, urticaria, and facial edema, have been reported with use of QULIPTA [see Adverse Reactions ( 6.2 )] . Hypersensitivity reactions can occur days after administration. If a hypersensitivity reaction occurs, discontinue QULIPTA and institute appropriate therapy [see Contraindications ( 4 )] . 5. 2 Hyper tension Development of hypertension and worsening of pre-existing hypertension have been reported following the use of CGRP antagonists, including QULIPTA, in the postmarketing setting. Some of the patients who developed new-onset hypertension had risk factors for hypertension. There were cases requiring initiation of pharmacological treatment for ...

Adverse reactions (label)

The following clinically significant adverse reactions are described elsewhere in the labeling: Hypersensitivity Reactions [see Warnings and Precautions ( 5.1 )] Hypertension [see Warnings and Precautions ( 5.2 )] Raynaud’s Phenomenon [see Warnings and Precautions ( 5.3 )] The most common adverse reactions (at least 4% and greater than placebo) are nausea, constipation, and fatigue/somnolence. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact AbbVie at 1-800-678-1605 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety of QULIPTA was evaluated in 2657 patients with migraine who received at least one dose of QULIPTA. Of these, 1225 patients were exposed to QULIPTA for at least 6 months, and 826 patients were exposed for 12 months. In the 12-week, placebo-controlled clinical studies (Studies 1, 2, and 3), 314 patients received at least one dose of QULIPTA 10 mg once daily, 411 pati...

Recent major label changes

Dosage and Administration ( 2.2 ) 9/2025 Warnings and Precautions ( 5.2 , 5.3 ) 3/2025

Source: FDA SPL label for Qulipta (AbbVie Inc.), effective 20250930. Full label on DailyMed.

Side-effect reports sent to the FDA

These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.

6,565reports that mention this drug
6,558of those blame this drug, not another one the person was taking
36%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
1.1%of reports include a death, from any cause (average for all drugs: 9.1%)

Problems reported most often

Migraine · 1,164Drug Ineffective · 792Headache · 642Nausea · 605Constipation · 453Fatigue · 425Dizziness · 265Therapy Interrupted · 197Off Label Use · 175Pain · 173Vomiting · 173Decreased Appetite · 171Therapeutic Product Effect Incomplete · 151Weight Decreased · 151Anxiety · 145

Reports per year

20192020202120222023202420252026
38281,6871,7149981,367758

14,861 reports blaming this drug for every million Medicare prescriptions filled, which is 5.4× the typical drug on this site. (3,118 reports in 2024–2026, against 209,816 Medicare fills in one year. This is the one number here that accounts for how many people take the drug.)

Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.

Recalls and regulatory record

0recall actions on file
1 / 0brand / generic applications
4label changes since 2021
NoREMS program

Evidence base

22randomized trials (PubMed)
7systematic reviews
36registered trials
63%of completed trials posted results
0%terminated or withdrawn
75%industry-funded

Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.

Money and lawsuits

In 2024, drug companies reported $8,093,271 in payments to US physicians and hospitals tied to this drug across 180,687 transactions (Qulipta $8,093,271).

No pending federal MDL names this drug or its brands.

Not named in any federal pharmaceutical settlement of $100M or more on record.

Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.

Who takes it and what it costs

45,046Medicare Part D patients (2024)
209,816prescriptions filled
$1,241average cost per fill
$260Mtotal Medicare spend

Same-class alternatives

1 drug in the same class grades a letter or more higher than atogepant on this site. Worth asking whether one of them would do the same job for you.

eptinezumaberenumabfremanezumabgalcanezumabzavegepant

Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.

Questions to ask your prescriber

  1. The most-reported problems in FDA's adverse event data are migraine, headache, nausea. How would we recognize and handle those?
  2. Why this one over eptinezumab, erenumab, fremanezumab? What would make you pick one of those instead?
  3. There is no generic. Is there an older generic in the same class that works as well for my situation?
  4. The manufacturer pays physicians heavily to promote this drug. Have you received anything from them?
  5. What result are we expecting, by when, and what is the plan if it does not happen?
  6. If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)