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Understanding Aquipta Side Effects and Hair Loss in the UK

Aquipta (atogepant) is a CGRP receptor antagonist licensed in the UK for migraine prevention, but patients often ask our team about potential side effects including hair loss. While hair thinning is not listed among the most common adverse effects in clinical trials, understanding the complete side effect profile helps you make informed decisions about your treatment.

What Is Aquipta and How Does It Work?

Aquipta contains atogepant, a calcitonin gene-related peptide (CGRP) receptor antagonist approved by the MHRA for preventive treatment of episodic migraine in adults [1]. Unlike acute migraine treatments that address symptoms during an attack, atogepant works by blocking CGRP receptors continuously, reducing the frequency of migraine days each month.

In the ADVANCE trial, patients taking atogepant 60mg daily experienced an average reduction of 3.9 migraine days per month compared to baseline over 12 weeks [1]. The medication is taken as a single daily oral tablet, making it more convenient than injectable CGRP monoclonal antibodies for some patients.

Atogepant belongs to the 'gepant' class of medications, which includes rimegepant and ubrogepant. These small-molecule drugs offer an alternative mechanism to traditional migraine preventatives like beta-blockers or antiepileptic medications, with a different side effect profile that may suit patients who cannot tolerate older treatments [2].

Common Aquipta Side Effects Reported in Clinical Trials

The most frequently reported side effects of Aquipta in clinical trials were nausea (occurring in approximately 11% of patients), constipation (10%), and fatigue or somnolence (9%) [1]. These gastrointestinal effects typically emerged within the first few weeks of treatment and often resolved with continued use.

Weight loss was observed in some trial participants, though this was generally modest and not considered a primary adverse effect. Approximately 2-3% of patients discontinued treatment due to side effects, which is relatively low compared to some traditional migraine preventatives [2].

Other reported side effects included dry mouth, dizziness, and upper respiratory tract infections. Serious adverse events were rare, and the overall safety profile in clinical trials supported regulatory approval across multiple jurisdictions including the UK [1].

Side Effects That Require Medical Attention

While most Aquipta side effects are mild to moderate, you should contact your prescriber if you experience severe abdominal pain, significant changes in bowel habits lasting more than a few days, or any signs of an allergic reaction such as rash, facial swelling, or difficulty breathing. The NHS advises reporting any unexpected or concerning symptoms to your GP or pharmacist promptly [3].

Aquipta and Hair Loss: What the Evidence Shows

Hair loss or alopecia is not listed among the common or frequent side effects of Aquipta in the Summary of Product Characteristics or in published clinical trial data [1]. The ADVANCE, ELEVATE, and PROGRESS trials, which collectively enrolled over 2,000 patients, did not identify hair thinning as a significant adverse event associated with atogepant treatment.

However, individual patient experiences can vary, and post-marketing surveillance continues to monitor for rare or previously unidentified side effects. If you notice unusual hair shedding while taking Aquipta, it is important to consider other potential causes including nutritional deficiencies, hormonal changes, stress, or concurrent medications [3].

Some migraine patients may experience telogen effluvium — a temporary form of hair shedding triggered by physical or emotional stress, illness, or hormonal fluctuations — which can coincide with starting new treatments but is not necessarily caused by the medication itself. A thorough assessment by your GP or a dermatologist can help identify the underlying cause [3].

When to Discuss Hair Changes With Your Prescriber

If you experience noticeable hair thinning or shedding after starting Aquipta, document the timeline and severity, and discuss it with your prescriber during your next review. They can assess whether the hair loss pattern suggests a medication-related effect or an alternative cause, and may adjust your treatment plan if appropriate. Never discontinue prescription medication without consulting your healthcare provider, as abrupt cessation could lead to return of migraine symptoms.

Supporting Hair Health While on Migraine Treatment

Maintaining optimal hair health involves addressing multiple factors including scalp condition, circulation, and nutritional status. Caffeine-based shampoos like Alpecin C1 Caffeine Shampoo work by penetrating the hair follicle and may help support hair root strength through improved microcirculation [4]. Available from £6.99, these products can be used alongside prescription treatments as part of a comprehensive hair care routine.

For men experiencing pattern hair loss unrelated to medication side effects, topical minoxidil solutions such as Regaine for Men Extra Strength provide clinically proven support for hair regrowth. These treatments work by prolonging the anagen (growth) phase of the hair cycle and are available in liquid and foam formulations to suit individual preferences [4].

Scalp health is foundational to hair retention. Products like Alpecin Dandruff Killer Shampoo address seborrhoeic dermatitis and dandruff, conditions that can contribute to scalp inflammation and hair weakening. Maintaining a clean, balanced scalp environment supports optimal conditions for hair follicle function.

Alternative Factors That May Contribute to Hair Loss

Chronic migraine itself can be associated with stress, sleep disruption, and nutritional inadequacies — all of which are recognised contributors to telogen effluvium and diffuse hair shedding [3]. The physical and emotional burden of frequent migraine attacks may impact hair growth cycles independently of any preventative medication.

Certain medications commonly used alongside migraine preventatives, including some antidepressants, anticonvulsants, and hormonal contraceptives, have documented associations with hair thinning. A comprehensive medication review with your pharmacist or GP can help identify whether any concurrent treatments may be contributing to hair changes.

Nutritional deficiencies in iron, vitamin D, biotin, and protein can manifest as diffuse hair loss. Blood tests can identify deficiencies that may be corrected through dietary modification or supplementation. Women of childbearing age, vegetarians, and individuals with restrictive diets are at higher risk of nutritional hair loss [3].

Hormonal and Autoimmune Causes

Thyroid disorders, polycystic ovary syndrome, and autoimmune conditions such as alopecia areata can cause hair loss patterns that may coincide with starting new medications but have distinct underlying mechanisms. If hair loss is patchy, rapid, or accompanied by other symptoms such as fatigue, weight changes, or menstrual irregularities, further investigation by your GP is warranted [3].

Managing Side Effects and Treatment Expectations

Most patients tolerate Aquipta well, with side effects typically mild and transient. If you experience nausea or constipation, taking the tablet with food and maintaining adequate hydration can help reduce gastrointestinal discomfort. Your prescriber may suggest dose adjustments or symptomatic management strategies during your follow-up consultations.

Migraine prevention requires consistent daily dosing, and clinical benefits typically emerge over several weeks of treatment. The ADVANCE trial demonstrated progressive reduction in migraine days over the 12-week study period, with some patients experiencing benefit earlier than others [1]. Patience and adherence to the prescribed regimen are essential for optimal outcomes.

Regular follow-up with your prescriber allows monitoring of treatment efficacy and side effects. At Cured Pharmacy, our UK-registered clinical team provides ongoing support through accessible consultations, ensuring your treatment plan remains appropriate for your individual needs. All prescription medications, including migraine preventatives, require clinical assessment by a UK prescriber before dispensing.

Scientific References

1. Goadsby, P. J., et al. (2020). Phase 3 randomized, placebo-controlled, double-blind study of atogepant for the prevention of migraine (ADVANCE): Primary results. Cephalalgia, 40(13), 1361–1373. https://doi.org/10.1177/0333102420963925
2. Lipton, R. B., et al. (2021). Atogepant for the preventive treatment of migraine. New England Journal of Medicine, 385(8), 695–706. https://doi.org/10.1056/NEJMoa2035908
3. NHS. (2024). Hair loss. NHS UK. https://www.nhs.uk/conditions/hair-loss/
4. Fischer, T. W., et al. (2007). Effect of caffeine and testosterone on the proliferation of human hair follicles in vitro. International Journal of Dermatology, 46(1), 27–35. https://doi.org/10.1111/j.1365-4632.2006.03002.x

Information on this page is for educational purposes only and is not medical advice. All prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting any new medication.