eptinezumab

General

Pronunciation:
ep-ti-nez-ue-mab


Trade Name(s)

  • Vyepti

Ther. Class.

vascular headache suppressants

Pharm. Class.

monoclonal antibodies

calcitonin gene-related peptide receptor antagonists

Indications

Migraine prevention.

Action

Monoclonal antibody that binds to the calcitonin gene-related peptide (CGRP) receptor, which reduces the neuroinflammatory and vasodilatory effects of CGRP.

Therapeutic Effect(s):

Reduction in frequency of migraines.

Pharmacokinetics

Absorption: IV administration results in compete bioavailability.

Distribution: Minimally distributed to tissues.

Metabolism and Excretion: Degraded by enzymatic proteolysis into small peptides and amino acids.

Half-life: 27 days

TIME/ACTION PROFILE (plasma concentrations)

ROUTEONSETPEAKDURATION
IVrapidend of infusionunknown

Contraindication/Precautions

Contraindicated in:

  • Serious hypersensitivity.

Use Cautiously in:

  • OB:   Safety not established in pregnancy;
  • Lactation:  Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
  • Pedi:   Safety and effectiveness not established in children.

Adverse Reactions/Side Effects

EENT: nasopharyngitis

Misc: HYPERSENSITIVITY REACTIONS (including anaphylaxis and angioedema)

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None reported.

Route/Dosage

IV (Adults): 100 mg every 3 mo; some patients may benefit from 300 mg every 3 mo.

Availability

Solution for injection: 100 mg/mL

Assessment

  • Assess frequency and intensity of migraines.
  • Monitor for signs and symptoms of hypersensitivity reactions (rash, angioedema, urticaria, facial flushing anaphylaxis) during and after infusion. If reaction is severe, discontinue eptinezumab and treat as needed.

Implementation

  • Intermittent Infusion:   Dilution:  For 100 mg dose,  withdraw 1 mL eptinezumab and dilute in 100 mL 0.9% NaCl.  For 300 mg dose,  withdraw 1 mL eptinezumab from each of 3 vials and dilute in 100 mL 0.9% NaCl. Gently invert to mix; do not shake. Infusion bags must be made of polyvinyl chloride (PVC), polyethylene (PE), or polyolefin (PO). Solution is clear to slightly opalescent, colorless to brownish-yellow; do not infuse solutions that are cloudy, discolored, or contain particulate matter. Infuse within 8 hr.
  • Rate: Infuse over 30 min through a 0.2 micron or 0.22 micron in-line or add-on sterile filter. Flush line with 20 mL of 0.9% NaCl.

Patient/Family Teaching

  • Instruct patient to notify health care professional immediately if signs and symptoms of hypersensitivity reaction (swelling of face, mouth, tongue or throat, trouble breathing, rash) occur.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
  • Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Decrease in frequency and intensity of migraines.