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Eptinezumab parenteral

Updated 2 Feb 2023 | Migraine prophylaxis

Presentation

Infusions of eptinezumab.

Drugs List

  • eptinezumab 100mg/1ml solution for infusion vial
  • VYEPTI 100mg/1ml solution for infusion vial
  • Therapeutic Indications

    Uses

    Migraine in adults: prophylaxis

    Prevention of migraine in adults who experience 4 or more migraine days per month.

    Dosage

    Adults

    100mg once every 12 weeks. Some patients may benefit from an increased dose of 300mg once every 12 weeks.

    The need for an increased dose should be assessed within 12 weeks of initiation of treatment. When changing dosage, the first dose of the new regimen should be given on the next scheduled dosing date.

    Administration

    For intravenous infusion over 30 minutes, following dilution.

    Contraindications

    Children under 18 years
    Hereditary fructose intolerance
    Pregnancy

    Precautions and Warnings

    Breastfeeding

    Treatment to be initiated and supervised by a specialist
    Contains polysorbate
    Presentations with sorbitol unsuitable in hereditary fructose intolerance
    Concentrate must be diluted and used as an infusion
    Do not use if any signs of precipitate or particulate matter apparent
    Record name and batch number of administered product
    Evaluate need for continued treatment after 6 months
    Discontinue if severe hypersensitivity reactions occur

    Pregnancy and Lactation

    Pregnancy

    Eptinezumab is contraindicated during pregnancy.

    Use of eptinezumab during pregnancy is contraindicated by the manufacturer. At the time of writing, there is limited published information regarding the use of eptinezumab during pregnancy. Potential risks are unknown, however human IgG is known to cross the placenta and therefore eptinezumab is expected to cross the placenta and transfer to the foetus.

    Lactation

    Use eptinezumab with caution during breastfeeding.

    The manufacturer does not recommend breastfeeding whilst taking eptinezumab. During the first few days after birth, human IgG is known to be excreted in breast milk and therefore a risk to the breastfed infant cannot be excluded during this period. Following this period, the use of eptinezumab during breastfeeding should only be considered if clinically necessary. LactMed (2020) notes that due to the large molecular weight of eptinezumab (143,000 Da) the amount of eptinezumab in breast milk is expected to be low and absorption unlikely due to the likelihood of eptinezumab being destroyed in the infants gastrointestinal tract.

    Side Effects

    Anaphylactic reaction
    Fatigue
    Hypersensitivity reactions
    Nasopharyngitis

    Overdosage

    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

    Further Information

    Last Full Review Date: October 2022

    Reference Sources

    Summary of Product Characteristics: Vyepti 100mg concentrate for solution for infusion. Lundbeck Limited. Revised January 2022.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at: https://www.ncbi.nlm.nih.gov/books/NBK501922/
    Eptinezumab. Last revised: 20 July 2020
    Last accessed: 19 October 2022

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