CGRP inhibitors- IV Vyepti and Emgality shots

Greetings - These are great questions. I know it can feel like a lot to take on new treatments as it potentially means experiencing side effects and can take time to both get it to the right level in your system- and then, if it doesn't work out, waiting out challenges while we wean off of it.


Interesting to hear you've tried Nurtec. This is also in the CGRP family- but there are many different types of these meds out there. Some are preventative; others are rescue, and still others do both! We've heard many people say that just because one CGRP doesn't work for them doesn't mean they all won't.


I personally take Emgality (and, like you, Botox). I've had success with it in that it helps decrease some of the intensity of the pain I experience. It didn't have any impact on the frequency of my attacks. We are all so different in our pain patterns and how or whether we respond to treatments. That said, I've had no discernable side effects. I notice, just like with the Botox, that I can tell when I'm nearing the end of the efficacy window as the drug wears out in my system before it's time to take it again. We have some good information here from others who are taking Emgality regarding side effects, efficacy, and on: https://migraine.com/forums/side-effects-emgality.


I haven't personally tried Vyepti - but have heard a lot about it. We have a lot of resources on this topic - and the best way to take a look at those is to go to our search bar (top left corner of the web page) and then enter "Vyepti" into that bar. That will take you to a list of resources on this approach.


Wonderful that you are working so hard to try new solutions to address your constant pain related to chronic migraine. I also live with chronic migraine so can understand what you're up against. I have found, like you, that the best chance of experiencing some relief is to seek a combination of medications that make up an overall strategy of preventative and rescue approaches. As there is no one cure for migraine, the goal is to address the symptoms of the condition to decrease the severity and/or frequency of pain and related neurological symptoms.


Do you have a rescue tactic in your overall treatment strategy? I think of Botox and gabapentin as being preventative. What do you do when you have breakthrough pain? I take a triptan as my rescue. It works just okay- but sometimes taking the edge off the intensity can make a huge difference.


So glad you're with us and willing to share your journey. Hope you'll keep in touch, Warmly - Holly - migraine.com team

Thank you for your response. I currently use Tylenol for rescue, Nurtec works sometimes, does not work most of the times. sumatriptan/rizatriptan does not work well for me. I recently read about frovatriptan on migraine.com and plan to ask my doctor about it.

Has anyone tried emgality, amivog, and they didn’t work and then try Avjoy? I probably am spelling them wrong. I was on both for 6 months and nothing only fat in the stomach. Now after 2 years I am going to try Avjoy and I am a little scared. I have been having horrible migraines, but every time I take a rescue med eltriptriphan I get rebounds because they work and I guess it takes away the headache and then I take too much. I mean every time I get one and then I get rebounds. However, I am so nervous to try another CGRP because none seem to have work and I gain weight. My headache specialist seems to think I should try. So has anyone tried two and then a third one worked? Thank u