Acute Treatment of Vestibular Migraine by Rimegepant

Prior treatment

• Known pregnancy or lactation, or a positive pregnancy test prior to randomization.
• Initiation or dose adjustment of any preventive migraine therapy within 3 months prior to study drug administration.
• Use of any other anti-vertigo or analgesic medication within 6 hours before study drug administration.

Other illness

• Presence of other disorders causing acute vestibular symptoms (e.g., Ménière's disease, otitis media).
• Coexisting non-vertiginous dizziness (e.g., dizziness due to panic disorder), unless the patient can clearly distinguish these episodes from vestibular-migraine attacks.
• Severe cardiovascular or cerebrovascular disease.
• Contraindication or hypersensitivity to any medications used in the study.
• Any other condition that, in the investigator's judgment, makes the participant unsuitable for the study or poses significant risk.

Lab values

• Severe hepatic dysfunction (ALT and/or AST \>3× upper limit of normal) or renal impairment (creatinine clearance \<30 mL/min).

Other

• Alcohol abuse or substance abuse.
• Participation in another interventional clinical study that could affect outcome assessment.

• Age 18-60 years, male or female.
• Diagnosis of vestibular migraine according to the Bárány Society criteria.
• ≥4 episodes of characteristic vestibular symptoms in the past year, each of moderate to severe intensity and lasting \>2 hours (without intervention).
• Signed informed consent obtained from the participant.