Vyepti (eptinezumab-jjmr) is an intravenous (IV) infusion medication used to prevent migraine episodes in adults. It contains the active ingredient eptinezumab-jjmr, a biologic medication made from living cells. Vyepti is not used to treat migraine symptoms when they occur but helps prevent them. It is available only as the brand-name drug Vyepti.
Understanding Migraine and Vyepti's Role
Migraine headaches can range from moderate to severe, lasting from 4 to 72 hours. Migraine pain typically affects one side of the head and may be accompanied by nausea, vomiting, and sensitivity to light or sound. Some individuals experience aura symptoms, such as flashes of light, tingling in the hands or feet, or vision problems, before or during a migraine episode.
Vyepti is an antibody and belongs to a class of drugs called CGRP (calcitonin gene-related peptide) blockers. These drugs work by attaching to the CGRP protein, preventing it from binding to receptors in the brain. This binding is thought to result in migraine pain. By blocking this process, Vyepti helps prevent migraine pain.
How Vyepti Works: Mechanism of Action
Vyepti is part of a group of drugs called CGRP blockers. These drugs work by attaching to a protein called CGRP.CGRPs bind to other proteins in the brain called receptors, which act as docking stations. It’s thought that this binding results in migraine pain.Vyepti attaches to CGRPs so that these proteins can’t bind to their receptors. This helps to prevent migraine pain.
Dosage and Administration
Vyepti is administered as an IV infusion by a healthcare professional. The standard dose is 100 mg, administered intravenously every three months. Some patients may benefit from a higher dose of 300 mg, depending on the severity of their migraine episodes and how well Vyepti works for them. The IV infusion takes approximately 30 minutes.
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What if You Miss a Dose?
If you miss an appointment for a Vyepti infusion, contact your doctor's office to reschedule. Missing a dose may lead to the return of migraine episodes.
Long-Term Use
Vyepti may be needed long-term to help prevent migraine episodes. If the medication is effective and side effects are manageable, your doctor may recommend long-term use.
Onset of Action
Vyepti works quickly, and some individuals may notice a decrease in migraine episodes within the first three months. Improvement is typically measured by the number of migraine days a person experiences over three months. Vyepti also exhibited a benefit over placebo as early as the first day after treatment, according the studies conducted by the manufacturer.
Potential Side Effects of Vyepti
Like most medications, Vyepti can cause side effects, but they aren't common. It’s important to remember that side effects can vary depending on individual factors such as age, other health conditions, and other medications being taken.
Mild Side Effects
Mild side effects that have been reported with Vyepti include:
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- Cold-like symptoms: These may include a sore or scratchy throat and a stuffy nose. These symptoms are generally mild to moderate.
- Infusion-related side effects
- Infection of the throat and nose
These side effects are usually temporary, resolving within a few days to a couple of weeks. If they become bothersome, consult your doctor or pharmacist.
Serious Side Effects
Serious side effects from Vyepti are rare, but can occur. If you experience any serious side effects, contact your doctor immediately.
- Allergic reaction: Symptoms can include skin rash, itchiness, flushing, and hives. In rare cases, a severe allergic reaction (anaphylaxis) can occur, with symptoms such as swelling under the skin (typically in the eyelids, lips, hands, or feet) and swelling of the tongue, mouth, or throat, which can cause trouble breathing.
- Hypersensitivity or infusion-related reactions (rash, flushing, itching)
- Possible increased risk of infection (very uncommon)
- Raynaud’s phenomenon: a type of circulation problem that can occur or get worse after receiving this treatment. You may notice your fingers or toes feeling numb, cool, painful or changing color (from pale to blue to red).
- New or worsening high blood pressure
Side Effect Focus
- Cold-like Symptoms: To help prevent getting a cold after a Vyepti infusion, wash your hands often, avoid touching your face with unwashed hands, and keep your distance from people who are sick.
- Allergic Reaction: Most allergic reactions occurred during Vyepti infusions and were not serious. However, they often led to stopping the drug or required treatment.
Addressing Common Concerns
- Weight Gain: Weight gain was not reported as a side effect in studies of Vyepti.
- Hair Loss: Hair loss was not reported as a side effect in studies of Vyepti.
- Fatigue: Vyepti has not been shown to cause fatigue in clinical studies conducted by the manufacturer.
- Digestive Side Effects: Vyepti is not known to cause digestive side effects.
Warnings and Precautions
Before starting Vyepti treatment, discuss your health history with your doctor. Certain medical conditions may affect whether Vyepti is right for you.
- Raynaud Phenomenon: Tell your doctor if you have a personal or family history of Raynaud phenomenon.
- High Blood Pressure: If you have high blood pressure, talk with your doctor before starting treatment with Vyepti. During treatment, your doctor will monitor your blood pressure.
- Age: Vyepti hasn’t been studied much in adults ages 65 years and older.
- Allergic Reaction: If you’ve had a serious allergic reaction to Vyepti or any of its ingredients, your doctor will likely recommend that you don’t receive Vyepti.
Vyepti and Other Considerations
Interactions
Currently, there are no known interactions between Vyepti and other drugs, vitamins, supplements, or herbs. However, it is essential to inform your doctor about all medications and supplements you are taking.
Vyepti and Alcohol
Vyepti is not known to interact with alcohol. However, alcohol may trigger migraine episodes in some individuals.
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Pregnancy and Breastfeeding
The safety of Vyepti during pregnancy and breastfeeding is unknown. Discuss the risks and benefits of Vyepti treatment with your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
Vyepti vs. Other Migraine Medications
Vyepti belongs to the same class of medications as Aimovig (erenumab-aooe), CGRP blockers that help prevent migraine episodes.
Alternative Medications:
- Emgality (galcanezumab): Monthly injectable CGRP antibody.
- Aimovig (erenumab): Monthly CGRP receptor antibody.
- Ajovy (fremanezumab): Monthly or quarterly injection.
- Botox (onabotulinumtoxinA): For chronic migraine prevention.
- Nurtec ODT (rimegepant): Oral CGRP receptor antagonist used for acute and preventive therapy.
Questions to Ask Your Doctor
- How will Vyepti affect my body, mood, or lifestyle?
- Which natural remedies can I take with Vyepti to prevent migraine episodes?
- Can Vyepti cure migraine?
- How can I switch from Vyepti to Aimovig?
- Can Vyepti be used to prevent other types of headaches?
- Can I take pain relief medication if I have a headache due to migraine on the day I receive a Vyepti infusion?
Important Considerations
- Vyepti is administered by a healthcare professional as an IV infusion, typically every three months.
- Vyepti is used to prevent migraine episodes and is not intended to treat acute migraine symptoms.
- Cost may be a factor when considering Vyepti. Discuss potential savings programs with your doctor or pharmacist.