Rimegepant and Breastfeeding

Summary of use during lactation

No information is available on the clinical use of rimegepant during breastfeeding. However, amounts in breastmilk are low and would not be expected to cause any adverse effects in breastfed infants. If rimegepant is required by the mother of an older infant, it is not a reason to discontinue breastfeeding, but until more data become available, an alternate drug may be preferred while nursing a newborn or preterm infant. Some experts recommend withholding breastfeeding for 8 to 12 hours after a dose.[1]

Drug levels in milk and infant serum

Maternal Levels. Twelve healthy women volunteers between 2 an6 6 months postpartum were given a single dose of 75 mg of rimegepant orally. Milk samples from complete emptying of both breasts were obtained 15 to 30 minutes before the dose and 1, 2, 4, 8, 12, 16, 24, 32, and 36 hours after the dose. Peak milk rimegepant levels averaged 169.6 mcg/L at an average of 2 hours after the dose. Average milk levels over the first 24 hours after the dose was 34 mcg/L, which translated into an average daily infant dose of 0.005 mg/kg or a relative infant dose of 0.51%.[2] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

Alternative drugs to consider

(Migraine Prophylaxis) Divalproex, Erenumab, Metoprolol, Nortriptyline, Propranolol, Topiramate, Valproic Acid; (Migraine Treatment) Eletriptan, Rizatriptan, Sumatriptan, Ubrogepant, Zolmitriptan

References

1. Ornello R, Maassen van den Brink A, Puledda F, et al. Migraine management during pregnancy, breastfeeding and in women planning pregnancy. Cephalalgia 2025;45:3331024251393945.41263702 PubMed
2. Baker TE, Croop R, Kamen L, et al. Human milk and plasma pharmacokinetics of single-dose rimegepant 75 mg in healthy lactating women. Breastfeed Med 2022;17:277–82.35049333 PubMed