Do gepants help reduce monthly migraines in patients with episodic migraine?
Oral gepants are approved for preventing episodic migraine. Clinical trials show they significantly reduce the number of monthly migraine days compared to placebo. Rimegepant, for example, reduces pain and symptoms when taken as needed and lowers monthly migraine frequency when taken every other day. Atogepant also reduces monthly migraine days in real-world studies.
What the research says
A 2023 review of rimegepant found it was more effective than placebo at reducing monthly migraine days when taken every other day for prevention. The beneficial effects on frequency and quality of life were maintained for up to 52 weeks 4. Rimegepant is also effective for acute treatment, relieving pain and the most bothersome symptom when taken as needed 4.
A 2025 real-world study of atogepant showed significant reductions in monthly migraine days after 12 weeks of daily treatment. About half of the patients achieved a 50% or greater reduction in monthly migraine days, a key measure of treatment success 6.
A 2024 network meta-analysis compared all CGRP therapies, including oral gepants and injectable antibodies. It found that all active CGRP treatments significantly reduced monthly migraine days versus placebo. While eptinezumab ranked highest overall, the gepants were confirmed as effective preventive options within the class 1.
What to ask your doctor
- How do rimegepant and atogepant compare for my specific migraine pattern?
- What is the best dosing schedule for me, every other day or daily?
- Are there any side effects I should watch for while taking a gepant?
- How long will it take to see a reduction in my monthly migraine days?
This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.