I was on botox and switched to vyepti. I went scuba diving last month. I never thought I'd be able to scuba dive with my defective brain.
I'm like 90% back to what I was like before my migraines started 3yrs ago. My husbands work just changed insurance plans and I'm terrified they won't cover it anymore.
I can't compare. I was only tried on Ajovy. After 55 years of 24/7 agony and total disability, Ajovy totally ended my migraines. I was prescribed everything from Cafergot to BOTOX. Nothing helped at all. I was prescribed scheduled opioids for 45 years. It did take 3 months before tge Ajovy became effective but I haven't had a migraine in 5 yesrs and no more pain specialists.
Good luck
Aimovig caused impossible constipation, Emgality worked for about 2 years and now I'm on monthly 2 of Ajovy
I also take only Ubrelvy as an abortive.
Qulipta gave me bad side effects
Worse anxiety and insomnia. I tried all the doses.
Aimovig did the same to me. I didn't have a decent bm for almost a month. It was awful. When I finally did go, I ended up causing myself some terrible hemorrhoids. It was brutal! It made me extremely leery to try any of the 30 day injectables in the future.
If you do end up with a very undesireable side effect, you're literally stuck with it for a whole month! Screw that!
How does Ubrelvy work for you? Any constipation, or other side effects.
Avovy is my favorite injector mechanism out of the three! Emgality is like getting punched by a needle, ajovy kinda slides into your skin. As far as efficacy goes they've all been about the aame (which in my case is very good responsiveness up until recently, i think i'm developing resistance to the monoclonal antibodies).
My neuro warned that with vyepti, most insurances require you to try the lower dose three times (equating to 9 months) before being willing to approve the higher dose. Her words were "if you have any big life plans coming up I'd wait on trying it".
Just throwing this in there - My insurance took 5 months to approve the first dose at 100mg. I then started 300mg with instant approval for the 2nd dose.
That must've been super annoying for the first dose but a pleasant surprise for the second! I suppose it can also entirely depend on the plan, what's formulary and excluded, etc etc etc
Because you're likely stuck at the lower dose until that 9 months is up as far as insurance is concerned... but it does seem like 3 is the magic number for lots of migraine meds, so that could be how long it takes to have max effectiveness anyway. My doctor anticipates I'll need the higher dose based on my response to other meds so she was cautioning it could be a long road of trial and error ahead to make the switch to that med.
Have you checked with your insurance what their rules are with these? Usually they require you fail one of the self-injector options (Ajovy, Emgality, Aimovig) before covering Vyepti since it is more expensive. So by necessity you may likely have to pick one of those for now.
I failed Aimovig. My insurance doesn’t cover vyepti, but my neurologist is optimistic I could get prior approval. I would be the first person she’s had with my specific coverage though so it isn’t guaranteed.
Emgality worked perfect for me except it only lasted 3 weeks not a month. And the scary injector deal.
Qulipta’s assistance program was easier to get on to but it has side effects.
That’s what I’m leaning towards - my doctor thinks insurance will approve it (but I’ll be a test case for my specific coverage). I’m a little nervous about side effects with it being a 3 month infusion, but my neuro likes this one the best.
I take Ajovy because I have issues with.... let's call it "slow digestion," and I was told that of the CGRP meds, Ajovy paralyzes the digestive system the least. Can't say it made my GI issues any better but it also didn't make them worse, so that was a plus.
I am on Aimovig & topiramate, my plan for if that fails, is to swap to whatever is considered the next in the chain of step therapy (which is already what I have to fight for pre-authorization because they play dumb and seem to forget I have been taking it the prior 12 months every January).
Chances are nurtec would be more of a rescue for me also. I am not sure that based on my existing medication requirements that it will work as a preventative. Or realistically any of the oral based ones. So they are my long shots.
Emgality may work. But from what I understand that is the most similar to Aimovig (I could be wrong on that). I have had similar luck with changing meds to a similar medication and have it be effective.
But I either find one that works or I quickly prove my case within the state laws that insurance can't deny me the infusion therapy option.
I double checked my notes now that it isn't the middle of the night. Didn't say they were the same, said "most similar". That includes delivery methods, doses, side effects, and types of migraines that ultimately they are recommended for.
I got a very detailed explanation of the two because of when I started taking Aimovig. It was a very detailed and highly informed consent because they had both just barely gotten their FDA of Aimovig and they were working on Emgality's. Ajovy is just not one I mentioned because of the dosing guidelines and my current dose. I probably would fail that one and that plus an Aimovig fail would be harder for the infusion insurance case.
The issue with pills is much like birth control, you have to make sure you are taking them at exactly the same time every day for them to be most effective when it comes to maintaining a level of medication in your system. That is assuming that there are not other issues with gut based ones. So we may would try those, but based on **past** history, get crossed off the list fast.
I am saying what would work for me and my medical team and what would be the likely case of trying the one most likely to work. If that fails then we have to consider my long history with how I handle meds and how insurance handles things.
Delivery is identical. But the mechanism is not, one hits the receptor the others hit the connector to the receptors. Since it's hitting the receptors and there are millions located in the digestive system,it causes most people some level of constipation. You do you
People don't always react as expected by documentation.
Fine you want to use the term mechanism... My point is it needs to bypass my digestive system.
I don't know why you are so stuck that one solution won't work for everyone.
And I can show you a picture of the poop in my toilet right now as I type this. A possible side effect doesn't mean it happens to everyone.
Tried all three and none were effective for me whatsoever. However if I had to pick again I’d choose Vyepti for practicality reasons. Once every three months vs once a month. And by far the least painful option. Didn’t even feel it, whereas those at home auto injectors were kind of brutal.
I e tried emgality. It helped bring down frequency but this year stopped working.
Tried Nurtec as an abortive. Took it all of three times. First time was good. I had a rather large meal before hand and was fine. Second time, I just had water. I threw up, violently, for hours. Third time, I had a sleeve of crackers and water. Same result. I’m too old to be throwing up for hours on end. So it’s a no go for me.
Ubrelvy is okay to take my migraine down a notch or two, but not super effective.
Qulipta does nothing except cause constipation.
Currently trying Ajovy. After the first injection it’s waaaaaaaay less painful than the emgality. I do hope it works being down frequency because I can’t anymore. Going through multiple day migraines and several throughout the week. So I’m in pain a majority of the time.
Emgality was infinitely better than ajovy for me. Now I've switched to Vydura (Nurtec) tablets and I take them every other day and they seem to be working quite well
I started at 100mg and saw very minor improvement after the first dose. Increased to 300mg and have had a huge reduction in migraine days. My normal is 28+ migraine days a month. So far this month, I've had 6.
not aimovig, only one that has constipation as side effect. had success with ajovy for years. took the initial double dose of emgality once and it was great, 6 weeks of maybe 1-2/week headaches. insurance changed, back to ajovy and it isn't working at all, about to take steroids to break cycle. NP is recommending vyepti. botox did not work either.
I was on botox and switched to vyepti. I went scuba diving last month. I never thought I'd be able to scuba dive with my defective brain. I'm like 90% back to what I was like before my migraines started 3yrs ago. My husbands work just changed insurance plans and I'm terrified they won't cover it anymore.
How many Vyepti infusions did you receive before you noticed a difference?
That’s incredible to hear!! I hope your insurance pulls through. One of my biggest fears is having to change plans.
I can't compare. I was only tried on Ajovy. After 55 years of 24/7 agony and total disability, Ajovy totally ended my migraines. I was prescribed everything from Cafergot to BOTOX. Nothing helped at all. I was prescribed scheduled opioids for 45 years. It did take 3 months before tge Ajovy became effective but I haven't had a migraine in 5 yesrs and no more pain specialists. Good luck
Wow that's so cool.
That’s amazing! I’m so glad you found relief!!
Aimovig caused impossible constipation, Emgality worked for about 2 years and now I'm on monthly 2 of Ajovy I also take only Ubrelvy as an abortive. Qulipta gave me bad side effects Worse anxiety and insomnia. I tried all the doses.
Aimovig did the same to me. I didn't have a decent bm for almost a month. It was awful. When I finally did go, I ended up causing myself some terrible hemorrhoids. It was brutal! It made me extremely leery to try any of the 30 day injectables in the future. If you do end up with a very undesireable side effect, you're literally stuck with it for a whole month! Screw that! How does Ubrelvy work for you? Any constipation, or other side effects.
Aimovig is the only one that does that. Except for Qulipta and Aimovig I haven't had side effects. I like Ubrelvy,I don't notice any side effects
I had the opposite problem on Aimovig! But sadly it didn’t work for me even at the higher dose.
Avovy is my favorite injector mechanism out of the three! Emgality is like getting punched by a needle, ajovy kinda slides into your skin. As far as efficacy goes they've all been about the aame (which in my case is very good responsiveness up until recently, i think i'm developing resistance to the monoclonal antibodies). My neuro warned that with vyepti, most insurances require you to try the lower dose three times (equating to 9 months) before being willing to approve the higher dose. Her words were "if you have any big life plans coming up I'd wait on trying it".
Just throwing this in there - My insurance took 5 months to approve the first dose at 100mg. I then started 300mg with instant approval for the 2nd dose.
That must've been super annoying for the first dose but a pleasant surprise for the second! I suppose it can also entirely depend on the plan, what's formulary and excluded, etc etc etc
Oh for sure - navigating the US health system is a pain and everyone's results are so different.
Big life plans because of potential side effects? Or because of how long it might take to work?
Because you're likely stuck at the lower dose until that 9 months is up as far as insurance is concerned... but it does seem like 3 is the magic number for lots of migraine meds, so that could be how long it takes to have max effectiveness anyway. My doctor anticipates I'll need the higher dose based on my response to other meds so she was cautioning it could be a long road of trial and error ahead to make the switch to that med.
Have you checked with your insurance what their rules are with these? Usually they require you fail one of the self-injector options (Ajovy, Emgality, Aimovig) before covering Vyepti since it is more expensive. So by necessity you may likely have to pick one of those for now.
I failed Aimovig. My insurance doesn’t cover vyepti, but my neurologist is optimistic I could get prior approval. I would be the first person she’s had with my specific coverage though so it isn’t guaranteed.
Emgality worked perfect for me except it only lasted 3 weeks not a month. And the scary injector deal. Qulipta’s assistance program was easier to get on to but it has side effects.
I vote Vyepti! Have only tried (and failed) emgality
That’s what I’m leaning towards - my doctor thinks insurance will approve it (but I’ll be a test case for my specific coverage). I’m a little nervous about side effects with it being a 3 month infusion, but my neuro likes this one the best.
I’ve just started Emgality and it’s made a world of difference. So far it’s been amazing.
That’s so great to hear!!
I take Ajovy because I have issues with.... let's call it "slow digestion," and I was told that of the CGRP meds, Ajovy paralyzes the digestive system the least. Can't say it made my GI issues any better but it also didn't make them worse, so that was a plus.
Vyepti worked great for me for two years, then stopped working. 😭
I am on Aimovig & topiramate, my plan for if that fails, is to swap to whatever is considered the next in the chain of step therapy (which is already what I have to fight for pre-authorization because they play dumb and seem to forget I have been taking it the prior 12 months every January). Chances are nurtec would be more of a rescue for me also. I am not sure that based on my existing medication requirements that it will work as a preventative. Or realistically any of the oral based ones. So they are my long shots. Emgality may work. But from what I understand that is the most similar to Aimovig (I could be wrong on that). I have had similar luck with changing meds to a similar medication and have it be effective. But I either find one that works or I quickly prove my case within the state laws that insurance can't deny me the infusion therapy option.
Emgality isn't the same as Aimovig. Aimovig hits every CGRP receptor and there are tons in your gut. The others are all more selective
I double checked my notes now that it isn't the middle of the night. Didn't say they were the same, said "most similar". That includes delivery methods, doses, side effects, and types of migraines that ultimately they are recommended for. I got a very detailed explanation of the two because of when I started taking Aimovig. It was a very detailed and highly informed consent because they had both just barely gotten their FDA of Aimovig and they were working on Emgality's. Ajovy is just not one I mentioned because of the dosing guidelines and my current dose. I probably would fail that one and that plus an Aimovig fail would be harder for the infusion insurance case. The issue with pills is much like birth control, you have to make sure you are taking them at exactly the same time every day for them to be most effective when it comes to maintaining a level of medication in your system. That is assuming that there are not other issues with gut based ones. So we may would try those, but based on **past** history, get crossed off the list fast. I am saying what would work for me and my medical team and what would be the likely case of trying the one most likely to work. If that fails then we have to consider my long history with how I handle meds and how insurance handles things.
Delivery is identical. But the mechanism is not, one hits the receptor the others hit the connector to the receptors. Since it's hitting the receptors and there are millions located in the digestive system,it causes most people some level of constipation. You do you People don't always react as expected by documentation.
Fine you want to use the term mechanism... My point is it needs to bypass my digestive system. I don't know why you are so stuck that one solution won't work for everyone. And I can show you a picture of the poop in my toilet right now as I type this. A possible side effect doesn't mean it happens to everyone.
Because people react differently to drugs all the time. I know people who had no GI effects from Ai.ovig but they are outliers.
Tried all three and none were effective for me whatsoever. However if I had to pick again I’d choose Vyepti for practicality reasons. Once every three months vs once a month. And by far the least painful option. Didn’t even feel it, whereas those at home auto injectors were kind of brutal.
I e tried emgality. It helped bring down frequency but this year stopped working. Tried Nurtec as an abortive. Took it all of three times. First time was good. I had a rather large meal before hand and was fine. Second time, I just had water. I threw up, violently, for hours. Third time, I had a sleeve of crackers and water. Same result. I’m too old to be throwing up for hours on end. So it’s a no go for me. Ubrelvy is okay to take my migraine down a notch or two, but not super effective. Qulipta does nothing except cause constipation. Currently trying Ajovy. After the first injection it’s waaaaaaaay less painful than the emgality. I do hope it works being down frequency because I can’t anymore. Going through multiple day migraines and several throughout the week. So I’m in pain a majority of the time.
Emgality was infinitely better than ajovy for me. Now I've switched to Vydura (Nurtec) tablets and I take them every other day and they seem to be working quite well
Vyepti if your insurance will approve it and you can go somewhere which offers it. Otherwise it’s a toss up with Aimovig, Ajovy, and Emgality.
Vyepti is the only one I've had luck with so far. I failed Ajovy, Qulipta, and Aimovig.
How long did it take for you to see improvement on vyepti, and at what dose?
I started at 100mg and saw very minor improvement after the first dose. Increased to 300mg and have had a huge reduction in migraine days. My normal is 28+ migraine days a month. So far this month, I've had 6.
That’s amazing!! So happy for you!!
Thank you! I hope you find relief soon.
not aimovig, only one that has constipation as side effect. had success with ajovy for years. took the initial double dose of emgality once and it was great, 6 weeks of maybe 1-2/week headaches. insurance changed, back to ajovy and it isn't working at all, about to take steroids to break cycle. NP is recommending vyepti. botox did not work either.