Eptinezumab (Vyepti®) is a calcitonin gene-related peptide (CGRP) monoclonal antibody used for the preventive treatment of migraine in adults.

 

It works by binding to CGRP, a protein involved in the development of migraine attacks, helping to reduce the frequency and severity of migraines.

 

It may be recommended if:

☐ Chronic migraine

☐ Episodic migraine

☐ Failure of previous preventive medications

☐ Intolerance to previous preventive therapies

☐ Frequent migraine-related disability

☐ Other

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EXPECTED BENEFITS

Treatment may:

☐ Reduce the number of migraine days per month

☐ Reduce migraine severity

☐ Reduce migraine duration

☐ Improve response to acute migraine medications

☐ Improve work or school attendance

☐ Improve quality of life

☐ Reduce emergency department presentations

☐ Improve daily functioning

I understand that treatment response varies between individuals and some patients may require more than one infusion before benefit is seen.

ALTERNATIVE TREATMENTS

Reasonable alternatives discussed include:

☐ Oral preventive medications

☐ Botulinum toxin (Botox®)

☐ Other CGRP monoclonal antibodies

☐ Neuromodulation therapies

☐ Lifestyle modification

☐ No treatment

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BEFORE STARTING TREATMENT

Before receiving Eptinezumab, I understand my clinician may review:

☐ My migraine diagnosis

☐ Previous migraine treatments

☐ Pregnancy status (where appropriate)

☐ Breastfeeding status

☐ Current medications

☐ Allergies

☐ Previous biologic therapy

☐ Previous infusion reactions

HAVE INFORMED MY CLINICIAN IF I HAVE

Current infection

Fever

Previous allergic reaction to biologic medicines

Pregnancy

Breastfeeding

Previous infusion reaction

Asthma

Significant cardiovascular disease

COMMON SIDE EFFECTS

☐ Nasal congestion

☐ Sore throat

☐ Fatigue

☐ Nausea

☐ Mild infusion site discomfort

☐ Flushing

☐ Mild dizziness

☐ Mild infusion reactions

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MATERIAL RISKS

Although serious complications are uncommon, I understand Eptinezumab may be associated with:

☐ Infusion reactions

☐ Allergic reactions

☐ Hypersensitivity reactions

☐ Delayed hypersensitivity

☐ Urticaria (hives

☐ Angioedema

☐ Facial swelling

☐ Difficulty breathing

☐ Severe allergic reaction

☐ Anaphylaxis (rare)

☐ Requirement for emergency treatment

☐ Hospital admission

INFUSION REACTIONS

Infusion reactions may occur during or shortly after treatment.

Symptoms may include:

☐ Flushing

☐ Rash

☐ Itching

☐ Hives

☐ Shortness of breath

☐ Chest tightness

☐ Wheezing

☐ Facial swelling

☐ Swelling of the lips or tongue

☐ Dizziness

☐ Low blood pressure

☐ Collapse

If these symptoms occur, the infusion may be stopped and emergency treatment commenced.

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PREGNANCY & BREASTFEEDING

I understand:

☐ There are limited data regarding the use of Eptinezumab during pregnancy.

☐ I should notify my treating clinician if I become pregnant.

I should discuss breastfeeding with my treating clinician.

LONG-TERM TREATMENT

I understand:

☐ Treatment is usually repeated every 12 weeks.

☐ Ongoing treatment depends on my clinical response.

☐ My clinician may recommend discontinuing treatment if sufficient benefit is not achieved.

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AFTER MY INFUSION

Following treatment I should seek medical advice if I develop:

☐ Rash

☐ Persistent swelling

☐ Difficulty breathing

☐ Fever

☐ Severe headache different from my usual migraine

☐ Persistent dizziness

☐ Chest pain

☐ Any symptoms that concern me

SEEK URGENT MEDICAL ATTENTION IF I EXPERIENCE

☐ Swelling of the face, lips or tongue

☐ Difficulty breathing

☐ Wheezing

☐ Severe rash

☐ Collapse

☐ Severe allergic reaction

 

PATIENT ACKNOWLEDGEMENT

I acknowledge that:

☐ My diagnosis has been explained.

☐ The reason Eptinezumab has been recommended has been explained.

☐ Expected benefits have been discussed.

☐ Reasonable alternatives have been discussed.

☐ I understand the common side effects.

☐ I understand the material risks relevant to my circumstances.

☐ I understand that allergic reactions and infusion reactions may occur.

☐ I understand emergency treatment may become necessary during my infusion.

☐ I understand that treatment effectiveness cannot be guaranteed.

☐ I understand that ongoing treatment depends upon my response.

☐ I have had sufficient opportunity to ask questions.

☐ My questions have been answered to my satisfaction.

☐ I understand I may withdraw my consent before treatment commences.