Alternatives to Qulipta If You Can't Fill Your Prescription

Alternatives to Qulipta for Migraine Prevention

If you can't fill your Qulipta prescription — whether it's because of availability issues, insurance problems, cost, or side effects — you still have options. Several other medications work similarly to prevent migraines, and your doctor can help you find the right fit.

In this guide, we'll explain what Qulipta is, how it works, and walk you through four proven alternatives for migraine prevention.

What Is Qulipta?

Qulipta (Atogepant) is a prescription medication made by AbbVie for the preventive treatment of episodic and chronic migraine in adults. It was approved by the FDA in September 2021.

Qulipta is an oral tablet taken once daily, available in 10 mg, 30 mg, and 60 mg strengths. It costs approximately $1,200 to $1,600 per month without insurance, and most plans require prior authorization for coverage.

For more details about Qulipta, including dosage and what to expect, see our guide: What Is Qulipta? Uses, Dosage, and What You Need to Know.

How Does Qulipta Work?

Qulipta belongs to a class of drugs called CGRP receptor antagonists (also known as gepants). CGRP stands for calcitonin gene-related peptide — a protein in your brain that plays a major role in triggering migraines.

During a migraine, CGRP levels spike, causing blood vessels to dilate and nerves to become inflamed, which leads to the throbbing pain, nausea, and sensitivity to light that migraine sufferers know all too well.

Qulipta works by blocking CGRP receptors, preventing CGRP from doing its job. This helps reduce the frequency and severity of migraine attacks before they start. For a deeper dive, read: How Does Qulipta Work? Mechanism of Action Explained.

Alternative 1: Nurtec ODT (Rimegepant)

Nurtec ODT is the closest alternative to Qulipta. Like Qulipta, it's an oral CGRP receptor antagonist (gepant), but with one key difference: Nurtec is approved for both acute migraine treatment and prevention.

For prevention, Nurtec is taken as a 75 mg orally disintegrating tablet every other day. For acute treatment, it's taken as needed when a migraine strikes.

Key facts about Nurtec ODT:

• Generic name: Rimegepant
• Manufacturer: Pfizer (Biohaven)
• How it's taken: Orally disintegrating tablet (dissolves on the tongue)
• Dosing for prevention: 75 mg every other day
• Cash price: Approximately $1,000 to $1,200 per month
• Common side effects: Nausea, stomach pain

Nurtec may be a good option if you want a single medication that can both prevent migraines and treat breakthrough attacks.

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Alternative 2: Aimovig (Erenumab)

Aimovig was the first FDA-approved CGRP treatment for migraine prevention. Unlike Qulipta, Aimovig is a monthly self-injection rather than a daily pill.

Aimovig works by targeting the CGRP receptor directly (similar to Qulipta), but it uses a monoclonal antibody that stays active in your body for about a month.

Key facts about Aimovig:

• Generic name: Erenumab
• Manufacturer: Amgen/Novartis
• How it's taken: Subcutaneous injection once monthly
• Doses: 70 mg or 140 mg
• Cash price: Approximately $700 to $800 per month
• Common side effects: Injection site reactions, constipation, muscle cramps

Aimovig is a good choice if you prefer a once-monthly injection over a daily pill and don't mind self-injecting.

Alternative 3: Ajovy (Fremanezumab)

Ajovy is another injectable CGRP antibody for migraine prevention. What makes Ajovy unique is its flexible dosing schedule — you can choose between monthly or quarterly injections.

Key facts about Ajovy:

• Generic name: Fremanezumab
• Manufacturer: Teva Pharmaceuticals
• How it's taken: Subcutaneous injection
• Dosing: 225 mg monthly OR 675 mg quarterly (three injections at once)
• Cash price: Approximately $650 to $750 per month
• Common side effects: Injection site pain, redness, swelling

Ajovy's quarterly dosing option is ideal if you want to minimize how often you need to think about your migraine prevention treatment.

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Alternative 4: Emgality (Galcanezumab)

Emgality is a monthly injectable CGRP antibody that targets the CGRP molecule itself (rather than the receptor). It's also the only CGRP treatment approved for both migraine prevention and episodic cluster headache.

Key facts about Emgality:

• Generic name: Galcanezumab
• Manufacturer: Eli Lilly
• How it's taken: Subcutaneous injection once monthly
• Dosing: 120 mg monthly after a 240 mg loading dose
• Cash price: Approximately $650 to $750 per month
• Common side effects: Injection site reactions, dizziness, constipation

Emgality may be worth considering if you also experience cluster headaches in addition to migraines.

How to Choose the Right Alternative

The best alternative depends on your individual situation. Here are some questions to discuss with your doctor:

• Do you prefer pills or injections? Nurtec ODT is the only oral alternative. Aimovig, Ajovy, and Emgality are all injections.
• Do you also need acute migraine treatment? Nurtec ODT can treat and prevent migraines. The others are prevention-only.
• How often do you want to take medication? Ajovy offers quarterly dosing. Aimovig and Emgality are monthly. Nurtec is every other day.
• What does your insurance cover? Coverage varies significantly. Your insurance may prefer one CGRP treatment over another.
• Do you have constipation issues? Qulipta and Aimovig are more likely to cause constipation than Ajovy or Emgality.

Final Thoughts

Not being able to fill your Qulipta prescription is frustrating, but the good news is that migraine prevention has more options than ever. Whether you try another oral gepant like Nurtec ODT or switch to an injectable CGRP antibody like Aimovig, Ajovy, or Emgality, your doctor can help you find an effective alternative.

Before switching, try using Medfinder to check if Qulipta is available at other pharmacies near you. You can also read our guide on how to find Qulipta in stock for more tips.

Related articles:

• Qulipta Side Effects: What to Expect
• Qulipta Drug Interactions: What to Avoid
• How to Find a Doctor Who Can Prescribe Qulipta