Gepants for stopping a migraine

The FAA's CACI – Migraine and Chronic Headache Worksheet lists ubrogepant (Ubrelvy) and rimegepant (Nurtec) among its relief/rescue medications with a 24-hour no-fly time and does not name zavegepant; the copy of that worksheet printed in the FAA's Migraine and Chronic Headache disposition table lists the same two with a 48-hour no-fly time. The documents do not say the same thing; all three are quoted. For prevention, the worksheet lists CGRP antagonists used only for prevention (prophylaxis) among its acceptable preventive medications, provided there are no side effects and a ground trial is completed; CGRP medication for migraine prevention has its own entry.

FAA rule for migraine medication: The FAA says migraine relief or rescue medication is acceptable when used occasionally and unacceptable for daily use, and that its post-dose observation time (no-fly warning) is based on the drug's half-life. It says that if several relief medications are needed on a recurring basis to stop symptoms, this is considered a complicated migraine, and the examiner should defer. For relief or rescue medication the worksheet lists, the FAA's CACI – Migraine and Chronic Headache Worksheet says the examiner can issue if the pilot meets all of its acceptable certification criteria, which include no more than one episode per month, no more than 2 outpatient clinic or urgent care visits for symptom exacerbation in the last 12 months (even if symptoms fully resolved), and no history of in-patient hospitalizations for headaches; it says narcotics, Fiorinal, Fioricet and Midrin are not acceptable for relief or rescue. FAA, Migraine Medication