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Indications and Dosage
Intravenous
Prophylaxis of migraine Adult: In patients who have at least 4 migraine days monthly: 100 mg every 3 months via infusion over approx 30 minutes, may increase dose to 300 mg every 3 months if necessary. Evaluate the need for dose escalation within the 1st 3 months; increased dose is given on the next scheduled date. Assess treatment 6 months after initiation.
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Reconstitution
Withdraw 1 mL from a vial then transfer to an IV infusion bag containing 100 mL of NaCl 0.9% solution for inj. Gently invert to completely mix. Do not shake.
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Special Precautions
Patient with a history of CV disease (e.g. hypertension, ischaemic heart disease), CV risk factors (e.g. diabetes, circulatory disease, hyperlipidaemia); uncontrolled and/or untreated psychiatric conditions, history of neurological diseases. Pregnancy and lactation.
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Adverse Reactions
Significant: Hypersensitivity reactions (e.g. anaphylaxis, angioedema, dyspnoea, urticaria, facial flushing, rash).
General disorders and administration site conditions: Infusion-related reactions, fatigue. Immune system disorders: Antibody development. Respiratory, thoracic and mediastinal disorders: Nasopharyngitis. |
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Monitoring Parameters
Monitor for signs and symptoms of hypersensitivity reactions; relief of headache symptoms.
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Action
Description:
Mechanism of Action: Eptinezumab, a recombinant humanised immunoglobulin G1 (IgG1) monoclonal antibody, binds to calcitonin gene-related peptide (CGRP) ligand and inhibits its binding to CGRP receptor, hence the downstream cascade of physiological activities linked to migraine attack initiation. Additionally, it inhibits α and β- CGRP-mediated neurogenic inflammation and vasodilation. Onset: Approx 1 day. Pharmacokinetics: Distribution: Central volume of distribution: Approx 3.7 L. Metabolism: Metabolised by proteolytic enzymes into small peptides and amino acids. Excretion: Elimination half-life: Approx 27 days. |
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Storage
Intact vial: Store between 2-8°C. Protect from light. Do not freeze or shake. Diluted solution: Store between 20-25°C or between 2-8°C; use within 8 hours. Do not freeze.
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MIMS Class
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ATC Classification
N02CD05 - eptinezumab ; Belongs to the class of calcitonin gene-related peptide (CGRP) antagonists preparations. Used to relieve migraine.
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References
Anon. Eptinezumab. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 12/01/2024. Anon. Eptinezumab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/01/2024. Buckingham R (ed). Eptinezumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/01/2024. Joint Formulary Committee. Eptinezumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/01/2024. Vyepti 100 mg Concentrate for Solution for Infusion (Lundbeck Limited). MHRA. https://products.mhra.gov.uk. Accessed 12/01/2024. Vyepti Concentrate for Solution for Infusion 100 mg/1 mL (Lundbeck HK Limited). MIMS Philippines. http://www.mims.com/philippines. Accessed 12/01/2024. Vyepti Injection (Lundbeck Pharmaceuticals LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 12/01/2024.
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