Changing Therapy: How I Started Vyepti

Changing therapy regimens has always been extremely stressful for me. Over the years, my body has proven to be quite resistant to various therapy regimens. It is one of the most frustrating and disappointing aspects of living with chronic migraine disease. I have found that the CGRP (calcitonin gene-related peptide) inhibitors have helped reduce the pain of my constant attacks. I have been using Emgality for almost two years. The efficacy target is four weeks, and for a year, I found that to be true for me. Over time, however, this waned from four weeks to three and then close to two weeks. Fortunately, I have Nurtec and a Nerivio device to get me through the latter two weeks.

Was getting Vyepti a challenge?

I had been researching Vyepti, and six months ago, I began talking with my doctor about switching to quarterly infusions. I provided her with my migraine tracking reports every month as part of my visit preparations. We began the process of getting the infusions approved by my insurance carrier in the second week of January. It took several weeks and multiple conversations with the doctor’s office and insurance carrier, but I was finally able to get my first infusion done in mid-June. The approval process was lengthy, but this has been the case for so many of my therapy regimens thus far. Sadly, doctor recommendations and orders are often trumped by the insurance carrier's desire to save money by denying your treatment, in my opinion.

How was my first infusion?

I traveled forty-five minutes to the approved infusion center. It was a small facility, but the care and professionalism of the staff were outstanding. There was no wait time at all as I was escorted to my infusion suite. They had rooms to accommodate any visitors you may bring with you, which was nice. The suite was set up nicely. All sorts of snacks, drinks, etc., were available, as was a large audio/visual center with wifi. I was set up in an oversized, plush chair for the infusion, which lasted about forty-five minutes or so. I was also given IV fluids after the Vyepti to ensure every drop of the medication made it inside me.

Was I nervous to get an IV?

My anxiety levels dropped considerably after I entered the infusion center. I was apprehensive about getting an IV. I’m not a fan of needles, but I understand their purpose. The most negative part of the infusion was the IV because the nurse could not find a suitable vein on the first try. The second stick worked! I didn’t feel either stick because my skin is tough. I’ll count that as a plus! During the infusion, the nurse checked on me several times. She asked if we needed anything, which I thought was a nice touch.

Was I concerned I'd have an allergic reaction?

I knew one of the most common side effects of the infusion was allergy-like. This was something I discussed with the nurse before the infusion as we finished up my paperwork. Out of an abundance of caution, she had Benadryl available to inject as part of the sterile preparations for me. This was another win, and it helped to reduce the anxiety of a possible reaction. Far too often, I’ve found myself sitting in the 1% of “this might happen to you,” so I like to be prepared if I can.

How am I doing 2 weeks later?

At this point, I am two weeks post-infusion with no notable side effects. My Emgality is typically spent at this point in the cycle as well. I do think the pain piece of my migraine cycles has edged up slightly, but right now, I am working with it. Vyepti is done every three months, and I hope my baseline will improve over time vs deteriorating. I have Emgality available still as a safety net would things start to get ugly. The oppressive heat and humidity combined with thunderstorms are upon us here in Florida, so I hope for the best as I prepare for the worst. If you have experience with Vyepti, please feel free to share it in the comments.