NICE has for the first time recommended an oral treatment for preventing migraines.

In final draft guidance published last week, rimegepant (Vydura from Pfizer) is approved as an option for preventing episodic migraine in adults where at least three previous preventive treatments have failed.

Episodic migraine is where a person has fewer than 15 migraine attacks per month. The draft guidance recommends rimegepant for adults who have at least four migraine attacks per month but fewer than 15.

Over 5.6 million people in England are thought to have episodic migraines.

Rimegepant is formulated as a wafer that dissolves under the tongue. It works by blocking release of calcitonin gene-related peptide (CGRP), which causes intense inflammation of the brain meninges and is thought to be responsible for the severe pain associated with migraine attacks.

The Migraine Trust welcomed the announcement but said it was “very disappointed” that rimegepant had not been approved for acute treatment.

The final guidance is expected in August.