Fellow migraineur Teri Roberts is an advocate for those with migraine. She’s the editorial director of the site Migraine Disease.org, an excellent resource for those searching for information when seeking treatment for migraine. http://migrainedisease.org
I am especially thankful of this migraine rock star for one of her suggestions that led me to finally find someone who specifically treats migraine patients. She did a feature story about finding her own and it spurred me to find mine: https://immersive.healthcentral.com/migraine/d/LBLN/living-with-migraine-trobert/flat/
I contacted a migraine specialist in West Chester, Ohio, the closest to Dayton, who I located on the site, mychronicmigraine.com. The receptionist I talked with didn’t completely discourage me, but she knew someone in the area who was a headache specialist: Dr. Glen Solomon. He had been a mentor to her boss. Dr. Solomon is a professor & chair of Internal Medicine & Neurology at Wright State University, but he used to head up the headache clinic at the Cleveland Clinic.
For the last 5 years, Dr. Solomon has been working to find preventive medications and emergency treatments for my migraine attacks. One of the best things he did was to pare down the number of medications I was taking. Most were the usual medications for treating fibromyalgia — hello, Lyrica! — that didn’t work and were dragging my body down.
I now take medication specifically for preventing migraine, as well as for interstitial cystitis symptoms, and treating high blood pressure. I use a muscle relaxer that helps fibromyalgia and insomnia.
Dr. Solomon studies the latest treatments and research on migraine. He’s not quick to try the latest treatments that come on the market until more research has been done and more patients’ testimonies are available.
I was very excited to hear about the three approved migraine preventive medications. In December 2018, Dr. Solomon prescribed Emgality (galcanezumab-gnlm). The medication is supposed to cut migraine days in half. You might have seen the pirates and princesses commercial, or a commercial where people ask a lady if she’s okay. (That last part for some reason makes me laugh and encourages me to provide my own snarky answers. But I digress….)
Emgality was approved Sept. 27, 2018. It is one of three FDA approved migraine preventive drugs “developed to bind to CGRP, a substance in the brain that may play a key role in migraine, and block its binding to the receptor.” He said he liked Emgality over Aimovig because it causes less chance of constipation.
During that visit, the nurse walked me through the process of giving myself a shot with a pre-loaded pen, not unlike an Epi-pen. The pre-loaded pen sat outside the refrigerator for 30 minutes. An insert provided with the medication showed me where I could choose to give the first two shots. I picked one in each leg.
Wellllll… I had to lie down after those two shots. Anxiety overtook me. The pen clicked as I pressed it down. I felt like that 10 seconds was a minute until I heard the second loud click. I felt hot, broke out in a cold sweat, and that pins and needles feeling took over. After that visit, I received a “pen” in the mail through Walgreens Specialty Pharmacy. Someone from the pharmacy calls me each month to make sure I’m still taking it and runs the prescription through insurance. The medication comes packed in ice packs inside a cooler.
I now use an ice cube over the area I am about to inject. My Dad, a diabetic, recommended the abdomen over legs for the spot to inject because there’s less chance of accidentally hitting a blood vessel. I have ready alcohol swabs, gauze, and a bandaid. The people at Lilly, the maker of this medication, also supplied a free sharps container. https://www.emgality.com/cluster/taking-emgality/sharps-container
Side effects are redness and pain at the site of injection. I’ve had a “goose egg” show up sometimes in the area I injected. Always the area becomes ridiculously itchy the next day. Now that it’s been 17 months in though, I have noticed these side effects do not last more than a few days.
I was able to try Emgality for a year free as an insured patient, and now my insurance covers the shot. I will link the savings information for it as well as these other anti-CGRP medications:
- Aimovig (erenumab-aooe): Approved May 17, 2018 (pre-loaded pen) https://www.aimovig.com/paying-for-aimovig/
- Ajovy (fremanezumab): Approved Sept. 14, 2018 (hypodermic needle, not pen, but you can give yourself doses 4X a year in 3 shots instead of one shot once a month) https://www.ajovyhcp.com/support/savings
- Emgality (galcanezumab-gnlm): Approved Sept. 27, 2018 (pre-loaded pen) https://www.emgality.com/savings
- Vyepti (eptinezumab-jjmr): Approved in February 2020 and available April 2020. It is the first and only intravenous preventive treatment for migraine. Patients receive 100 mg/mL of Vyepti in a 30-minute infusion every 3 months. (It sounds like a good thing if you don’t like giving yourself a shot at home.) https://www.vyeptihcp.com/vyepticonnect-support#financial-assistance
Let me know if you’ve tried Emgality or one of the other anti-CGRP medications available and what your results have been. I have noticed I am reaching less for my go-to rescue medication, Relpax (eletriptan). Like others reviewing these drugs though, I also notice it wears off a week before the next dose. At times, I’ve found I am treating a migraine for 2-3 days during that timeframe. I plan on asking my doctor if I might have better success with one of the other options, so I will keep you posted.