Aimovig, Ajovy and Emgality. Three
amazing new migraine prevention treatment options that I call the CGRP
injectables. They’re transforming the lives of people living with migraine and
with three options to choose from so many people are asking “Which CGRP is
right for me?” On this episode of The Headache Channel Welcome to the headache vlog I’m dr.
Alexander krob I’m a full time board-certified headache medicine doctor
and I’ve helped thousands of people living with headache
live better I created the headache vlog to provide a space for information that
you can use to live better too before we proceed with today’s episode a few
important notes first of all the headache vlog is for information and
entertainment purposes only it is not medical advice if you need
medical advice please see your doctor so the C GRP injectables aim of aghh a Jo V
and M gala tr3 amazing new preventive options that are really transforming the
lives of people living with migraine they are part of the most important
thing that someone living with migraine can do and that is to practice
prevention now prevention is not what you do when you get a migraine
preventive things tend to be things that you do on a regular basis whether or not
you have a migraine headache and the goals of prevention are to reduce the
number of days that you experience a migraine to make the attacks less severe
and to make them respond better to the treatments that you take when you do get
a migraine you should think about and talk to your doctor about prevention if
you are having four or more days of migraine in any given month or if you
are missing work or school or leaving early two or more days a month
prevention can take many forms often starting with lifestyle changes
including avoiding caffeine and getting regular sleep prevention can also
involve vitamins herbs and other nutritional supplements but for many
people migraine prevention involves taking one or more preventive
medications the traditional migraine preventive medications are what I call
the platform treatments and they are propranolol
amitriptyline divalproex or depakote and topiramate
also called topamax there’s also trow candy and other variations of topiramate
all of these medications are pills they’ve been around for years they were
not really created for headache diagnosis they were created for other
problems but used over the years and actually found to be helpful and they’ve
helped many people even Botox was created for cosmetic purposes and only
accidentally found to be helpful for migraine but what if you’ve tried these
and you’re still not getting to your goal of fewer migraines that’s where
these see GRP injectables come in these are really exciting new treatments for
the first time in the history of forever we have migraine treatments that weren’t
just found accidentally they were created with an understanding of how
migraines happen in the brain so we have these three exciting new treatments how
do you tell which one is best for you when you’re deciding about a medicine
there’s really four types of decision factors the first is effectiveness the
second one is side-effects or safety third we always think a little bit about
cost and fourth are various other factors your doctor and you will have a
conversation regarding the effectiveness and side-effects of the sea’ GRP
injectable medications this will be a short conversation because on the good
side these medications have very few side effects which we will get into
later and on the bad side none of these medications has been compared against
any of the others and so no one knows which medication is best for any
particular person or situation I will say that again no one knows which one of
these drugs is the best things like cost and various other factors are probably
more personal decisions that you will make on your own with that in mind let’s
look at which of these factors the C GRP injectables haven’t
and where there are differences that could be important for your decision
first let’s talk about similarities that all of these see GRP treatments have in
common to begin with these are all injections that you do yourself the
needles involved are all small and the injections are skin deep injection
techniques are similar you inject into healthy skin which means no tattoos
stretch marks scars veins or other abnormal skin you’re going to use clean
hands and clean the area with an alcohol swab before injecting also all of these
medicines can be injected once a month there is an exception that I’ll talk
about later they all share similar injection sites either the front of the
thigh or the tummy some of the medicines have other injection sites that you can
also use all of these medicines have to be refrigerated when you pick them up
from the pharmacy they should be cool to the touch and if they aren’t start
asking questions treat them like milk don’t put them next to the rotisserie
chicken keep them with the cool things and when you get home put them in the
fridge in their original box when you are ready to use them take them out of
the fridge and let them come to room temperature naturally for 30 minutes
don’t use hot water a microwave or a hairdryer these medicines also have no
interactions with any other medications so if you take medications for headache
or other conditions interactions should not be an issue and you should not have
to stop other treatments this means that the C GRP injectables are very different
from the platform drugs where side-effects and drug interactions were
fairly common unfortunately all of these medicines are very expensive they can be
500 or 600 dollars a month if you pay full retail price but they all come with
some form of savings program that can reduce your cost if you’re commercially
insured to about 5 dollars a month or less
at least for the first year or so all of these medicines can work really fast
often with results starting in the first month and they all have demonstrated
dramatic results in many cases some people are reporting fifty seventy-five
or even one hundred percent reduction in their migraine attacks these medications
also share similar side effects but the overall number of side effects is
actually quite few especially compared to the platform prevention treatments
the more common side effect that they all share is what is called an injection
site reaction and this happens somewhere around ten to thirty percent of the time
most people have had some kind of injection site reaction because most of
us have had a flu shot injection site reactions include things like feeling
the needle or getting a drop of blood or a bruise or an itchy or sore or red lump
or spot at or close to the injection site far less common are more serious
side effects and for the C GRP injectable drugs there are really two
one is sort of a milder allergic reaction like a rash and a more severe
one is angioedema which is swelling of the lips or tongue or even of the throat
now I have not seen any of these more serious reactions but they have been
reported to happen another thing these treatments have in common is that we
know nothing about their safety either good or bad when it comes to pregnancy
or breastfeeding so you shouldn’t use them if you are pregnant or
breastfeeding and because these medicines can stay in your body for five
months after your last dose you should stop them five or six months before
becoming pregnant we’ve now talked about features that all three see GRP
injectables have in common now let’s talk about some differences a movig was
the first C GRP injectable on the market it is available as either
a 70 or 100 40 milligram dose that you will take once a month you take a movig
using the auto injector which most people find very easy to use and not
that uncomfortable the important thing to understand about a movig is that in
addition to the two side effects that I mentioned that all of the SI GRP
injectables share aim of egg has an additional two side effects so all of
the SI GRP treatments share what are called injection site reactions and
share a slight chance of an allergic reaction which in rare cases can be
severe but for people with aim of egg constipation can be an issue in some
cases and in some of those cases constipation can be severe also for
people taking the 140 milligram dose some people have reported muscle cramps
it’s also important for people who are allergic to latex to understand that
this part of the injector this part right here it does contain natural latex
rubber and that could be a deciding point for some of you in addition to the
active ingredient in the aim of ink injection there are also some additives
including acetate polysorbate and sucrose aim of egg can be left at room
temperature for up to seven days but if you don’t use it within that seven day
period you have to throw it away and start with a fresh refrigerated dose like I said aim of egg retails at about
500 to 600 dollars a month but with the aim of egg savings card you can reduce
that cost to about $5 per dose and that’s good for 12 doses ii see GRP
injectable to hit the market is a Jovi and a Jovi is different from the others
in several ways first a Jovi comes as an injection of two hundred and twenty-five
milligrams that you can take every month or you can take three injections
same day every three months a Jovi currently comes as what’s called a
prefilled syringe that looks a lot like this demonstrator unit here in addition
to the two side effects that all see GRP drugs share and remember that’s
injection site reaction and allergic reaction a Jovi has no additional
recognized side effects additives in the a Jovi include EDTA histamine and
polysorbate you can keep a Jovi at room temperature for up to 24 hours but if
you don’t use it within that time you have to discard it and start again with
a refrigerated dose once you activate your a Jovi savings card you can get
your a Jovi treatments for 5 dollars a month the third C GRP injectable
treatment to hit the market is amulet II and in gala T is different from the
others in the following ways it’s available as either a prefilled syringe
or as this auto injector and each dose has 120 milligrams the auto injector
looks like this and when you do your first treatment with M gala T you’re
going to give yourself two injections after that it’s one injection a month
like a Jovie there are no additional side effects of M gala t other than the
two that I’ve mentioned which are injection site reaction and the chance
of an allergic reaction additives in the injection include histidine and
polysorbate you can leave this at room temperature for up to seven days before
you use it but if you don’t use it within that time you have to discard it
and start again with a fresh refrigerated dose the current M gala t
savings card lets you have a dose for zero dollars so I hope you have enjoyed
this episode on which C GRP is right for me if you need more information please
talk with your doctor you can also go to a moe
big calm a jovi calm or M gala D calm for the most up-to-date information on
each of the medications that we talked about today if you liked this episode
please give me a thumbs up and if you want up-to-date information on how to
live better when you’re living with headaches please hit the subscribe
button and don’t forget to ring the bell for reminders when new episodes are
posted thank you very much for watching I’m dr. Alexander krob and this has been
the headache vlog

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