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.

Potential Diagnoses

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.