Anti-CGRP monoclonal antibody (IV)
Eptinezumab
Brand names: Vyepti
Adult dose
Dose: 100mg IV q3 months (some patients 300mg q3 months)
Route: IV infusion
Frequency: q3 months
Clinical pearls
- NICE TA871: chronic and episodic migraine prevention after ≥3 prior preventives failed
- BASH and ABN migraine prevention guidance
- Quarterly IV dosing — alternative for those preferring infrequent dosing vs monthly SC CGRP mAbs
Contraindications
- Hypersensitivity
Side effects
- Nasopharyngitis
- Hypersensitivity / anaphylaxis
- Fatigue
- Injection/infusion reactions
Interactions
- No clinically significant CYP interactions
Monitoring
- Headache diary (days/month)
- Hypersensitivity at infusion
- Response review at 3–6 months
Reference: BNF; NICE TA871; ABN migraine; BASH; SmPC; https://bnf.nice.org.uk/drugs/eptinezumab/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Revised Original International Autoimmune Hepatitis Score (IAIHG) · Autoimmune Liver Disease
- Ho Index for Predicting Response to Medical Therapy in IBD · Inflammatory Bowel Disease
- MIDAS (Migraine Disability Assessment) · Headache
- Rh(D) Immune Globulin Dosage for Maternal-Fetal Haemorrhage · Haematology in Pregnancy
- AREDS Classification of Age-related Macular Degeneration · Macular Degeneration
- Diabetic Macular Oedema (DMO) Classification · Diabetic Retinopathy
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS