In renal or hepatic impairment, pick the agent whose clearance and safety profile truly fit the patient, and document why a familiar migraine drug was avoided.

Lasmiditan is preferred over gepants in dialysis-dependent renal failure; Severe hepatic impairment still allows carefully dose-reduced ubrogepant use; NSAIDs are often a poor choice when migraine coexists with chronic kidney disease; Naratriptan becomes unsafe when renal clearance is markedly reduced; Hepatic dysfunction magnifies opioid toxicity and can precipitate encephalopathy