The NHS is set to offer a medicated wafer that dissolves under the tongue to help prevent debilitating migraines.
Rimegepant, taken every other day, will be available only to adults who have tried at least three other preventative drugs and still have migraines on between four and 15 days every month.
It stops a protein that causes severe pain being released around the brain.
About 145,000 people a year could be offered it – but campaigners say some who could benefit may miss out.
Injections can target the same protein, calcitonin gene-related peptide (CGRP) – but this is the first oral option. And other medications – including beta-blockers, antidepressants and epilepsy drugs – do not work for everyone.
Rimegepant has been backed by the National Institutes of Health and Care Excellence, which makes decisions on drugs in England and whose recommendations are normally adopted in Wales and Northern Ireland.
NICE medicines-evaluation director Helen Knight said migraines were often an “invisible disability” and “blighted” millions of lives.
“Rimegepant is the first oral treatment for migraine to be recommended by NICE – and for many thousands of people, it is likely to be a welcome and more convenient addition to existing options for a condition that is often overlooked and undertreated,” she added.
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