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Ubrelvy

ubrogepant
small moleculeCGRP receptorOral small-molecule CGRP receptor antagonist (gepant)Acute treatment of migraine with or without aura
Species
MonkeyRat
Longest study
39 wk
Genotox
Conducted Conducted
Carcinogenicity
Conducted Conducted
Repro
Conducted Conducted
First dose
Not conducted Not stated publicly

Speciesopen answer page →

Species
Rat and rhesus monkey
“Pivotal 6- and 9-months PO studies in rat and monkey, respectively.”
✓ VerifiedFDA pharmacology/toxicology review, p. 17Source ↗
Why that species
Not stated in public reviews

The reviews list the species but not why. For small molecules, ICH M3(R2) expects one rodent and one non-rodent species, chosen with in vitro metabolism, protein binding and exposure data compared with human.

“In vitro metabolic and plasma protein binding data for animals and humans and systemic exposure data (ICH S3A, Ref. 7) in the species used for repeated-dose toxicity studies generally should be evaluated before initiating human clinical trials.”
✓ VerifiedICH 2009: ICH M3(R2): Guidance on Nonclinical Safety Studies for the Conduct…, p. 11Source ↗

Pre-IND readiness checklist →

Surrogate molecule
No surrogate; the clinical compound was tested
“The general toxicity of orally administered ubrogepant was assessed in CD-1 mouse (3-month), Wistar rat (7- and 14-day, 1-, 3-, and 6-month), and rhesus monkey (3- and 9-month) GLP-compliant studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 5Source ↗

Study lengthopen answer page →

Longest pivotal study
39 (9-month monkey)
“Pivotal 6- and 9-months PO studies in rat and monkey, respectively.”
✓ VerifiedFDA pharmacology/toxicology review, p. 17Source ↗
Pivotal GLP studies
6-month rat and 9-month rhesus monkey oral studies
“Pivotal 6- and 9-months PO studies in rat and monkey, respectively.”
✓ VerifiedFDA pharmacology/toxicology review, p. 17Source ↗
Route in tox
Oral
“Ubrogepant was administered orally in all toxicology studies.”
✓ VerifiedFDA pharmacology/toxicology review, p. 11Source ↗

Skipped studiesopen answer page →

Genotoxicity
Negative in Ames, in vitro chromosomal aberration and in vivo rat bone marrow micronucleus assays
“In genetic toxicology assessments, ubrogepant was negative in OECD-compliant Ames, in vitro chromosomal aberration, and in vivo rat bone marrow micronucleus assays.”
✓ VerifiedFDA pharmacology/toxicology review, p. 11Source ↗
Carcinogenicity
104-week CD-1 mouse and Wistar rat oral studies: no drug-related neoplasms
“In adequately designed and conducted 104-week oral carcinogenicity studies in CD-1 mouse (0, 5, 15, and 50 mg/kg/day) and Wistar rat (males: 0, 10, 30, and 100 mg/kg/day; females: 0, 10, 30, and 150 mg/kg/day), ubrogepant was negative for drug-related neoplasms.”
✓ VerifiedFDA pharmacology/toxicology review, p. 7Source ↗
Reproductive & developmental
Rabbit EFD: embryofetal mortality; rat PPND: lower offspring body weight; both at maternally toxic doses
“In animal studies, adverse effects on embryofetal development were observed following administration of ubrogepant during pregnancy (increased embryofetal mortality in rabbits) or during pregnancy and lactation (decreased body weight in offspring in rats) at doses greater than those used clinically and which were associated with maternal toxicity”
✓ VerifiedUS prescribing informationSource ↗
Safety pharmacology
hERG negative; no respiratory (75 mg/kg) or cardiovascular (300 mg/kg) effects in telemetered rhesus monkeys
“Ubrogepant was negative in an in vitro hERG assay. There were no effects on respiratory or cardiovascular parameters at oral doses up to 75 mg/kg or 300 mg/kg, respectively, in telemetered Rhesus monkeys.”
✓ VerifiedFDA pharmacology/toxicology review, p. 11Source ↗

First doseopen answer page →

First-in-human starting dose
Not stated in public reviews
Why it's blank

The public FDA and EMA reviews of Ubrelvy don't say how the first human dose was chosen. That rationale is in the IND, which is confidential, so it is missing for most approved products.

How it's usually set for small molecules outside oncology

Find the highest dose with no adverse effects (NOAEL) in each animal species, convert it to a human equivalent dose, usually by body surface area, pick the most appropriate species, then divide by a safety factor (default 10) to get the maximum recommended starting dose.

“In general, one should consider using a safety factor of at least 10. The MRSD should be obtained by dividing the HED by the safety factor.”
✓ VerifiedFDA 2005: Estimating the Maximum Safe Starting Dose in Initial Clinical…, p. 7Source ↗
This product's starting point

NOAEL / key findings: No adverse findings up to 160 mg/kg (6-month rat) and 175 mg/kg (9-month monkey) (FDA pharmacology/toxicology review, p. 11)

Full method, every step sourced →

NOAEL / key findings
No adverse findings up to 160 mg/kg (6-month rat) and 175 mg/kg (9-month monkey)
“In the 6-month rat (up to 160 mg/kg) and 9-month monkey (up to 175 mg/kg) studies, there were no adverse findings.”
✓ VerifiedFDA pharmacology/toxicology review, p. 11Source ↗

Risksopen answer page →

Immune & cytokine safety
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Biodistribution & persistence
Widely distributed to most tissues and rat milk at concentrations similar to blood
“Following oral administration to rats and monkeys, [14C]ubrogepant was approximately 23% bioavailable and was widely distributed to most tissues and milk (rat) at similar concentrations to blood.”
✓ VerifiedFDA pharmacology/toxicology review, p. 18Source ↗
Modality-specific risk
Hepatotoxicity and coronary artery vasoconstriction potential
“In addition, the sponsor conducted studies to investigate the potential for ubrogepant to constrict human coronary arteries and to further assess the risk of hepatotoxicity.”
✓ VerifiedFDA pharmacology/toxicology review, p. 4Source ↗

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