Infusion or intravenous (IV) therapy for migraine is a treatment used to help avoid a migraine headache or ease the symptoms of one. It delivers medicine straight into your vein through a needle.
Infusion therapy sends migraine medicine directly to your bloodstream, which means faster symptom relief compared to medicines you take by mouth.
There are two types of infusion therapy for migraine:
- Eptinezumab-jjmr (Vyepti) is in a class of medicines called monoclonal antibodies. You take it to prevent migraines from happening. It works by binding to a certain protein inside your body, stopping it from activating receptors that may trigger migraine.
- Dihydroergotamine (DHE) is a medicine that soothes migraine symptoms as they happen. It tightens blood vessels and prevents swelling by blocking certain substances naturally found in your brain. DHE comes as a nasal spray, injection, or IV infusion.
Vyepti, available since 2020, is the only FDA-approved infusion treatment for preventing migraine. In 2021, the FDA approved DHE as a nasal spray for treating migraine, but you can still take it as an IV at a hospital or infusion center.
How Do I Take Infusion Therapy?
Before infusion therapy
Before you begin treatment, hospital staff will take your blood pressure and other vital signs. If you’re taking DHE, you’ll also need blood work and an EKG, which records your heart’s electrical signals. DHE narrows your blood vessels and can lead to chest pain, so your doctor will want to make sure you don’t have any heart problems before starting treatment.
You may also take medicines to ward off a queasy stomach, pain, inflammation, or an allergic reaction before your infusion therapy session.
During infusion therapy
A nurse will insert a needle into a vein in either the top of your hand or in your arm. The needle connects to a small tube and an IV bag filled with your migraine medicine, which will slowly flow into your bloodstream.
The length of your infusion therapy session depends on the type of medicine you’re taking. With Vyepti, it could last anywhere from 30 minutes to a few hours. And if you’re having a DHE treatment, you’ll check into the hospital for about 4 days, where you’ll get a dose of the medicine every 8 hours until your migraine goes away or you’ve taken the maximum amount.
During your treatment, take time to relax. You can nap, watch TV, read, or listen to music. It should also be OK to eat and drink as normal, but check with hospital staff first. If you need to use the bathroom, ask to pause your treatment.
After infusion therapy
As with all medications, there’s a chance you could have side effects after infusion therapy. Watch for serious reactions like chest pain, trouble breathing, swelling of your face, mouth, tongue, or throat, and itching. Get emergency medical help right away if you have these side effects.
You could need follow-up sessions for several days in a row to feel the full effect of infusion therapy. You’ll usually take Vyepti every 3 months to avoid migraines and DHE only when you have migraine symptoms.
Infusion Therapy vs. IV Hydration Therapy
You may have heard of IV hydration therapy or IV drips to treat everything from hangovers to chronic pain. While these may sound similar to infusion therapy, there are important differences:
- Where you have therapy. You’ll have infusion therapy in a hospital or infusion center under the guidance of medical professionals. IV drips are done in an IV bar, lounge, or spa and may not be fully regulated.
- FDA approval. The FDA has not approved IV drips, meaning researchers have not done clinical studies on them. Infusion therapy for migraine is FDA-approved.
- What’s in the IV. Infusion therapy uses prescription medicine to treat migraine, while IV drips typically use a cocktail of nutrients, vitamins, electrolytes, and antioxidants.
How Well Does Infusion Therapy Work to Treat Migraine?
Eptinezumab-jjmr (Vyepti)
Researchers have studied this drug in people with two types of migraine:
- Chronic migraine means you have at least 15 headaches every month and more than half of them are migraines.
- Episodic migraine means you have between four and 14 headaches every month and at least four of them are migraines.
Study results show that Vyepti can lower the number of migraine days in people with both types. Those with chronic migraine had an average of 23 fewer migraine days per treatment, while people living with episodic migraine had an average of 12 fewer. The results lasted 3 months after one treatment.
Dihydroergotamine (DHE)
In one study, people with hard-to-treat migraine took 1 milligram of DHE in the hospital over 1 to 3 days. Nearly all, 97%, had less migraine pain, while 60% to 78% were pain-free after treatment. But researchers noted that IV DHE has more side effects like dizziness and nausea than the DHE nasal spray.
Show Sources
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SOURCES:
Headache: “Reduced adverse event profile of orally inhaled DHE (MAP0004) vs IV DHE: potential mechanism,” “Dihydroergotamine (DHE) – Then and Now: A Narrative Review.”
Vyepti: “Study Results: People on VYEPTI had more migraine-free days,” “How VYEPTI Works: Designed to help prevent migraine attacks.”
Houston Methodist: “Do IV Hydration Therapy & IV Vitamin Therapy Really Work?”
American Migraine Foundation: “Dihydroergotamine (DHE) For Migraine Treatment.”
American Headache Society: “Dihydroergotamine mesylate nasal spray receives FDA approval for the acute treatment of migraine in adults,” “Breaking News: Eptinezumab-jjmr (VYEPTI™) Approved by FDA.”
MedlinePlus: “Eptinezumab-jjmr Injection,” “Dihydroergotamine Injection.”
Premier Health: “Infusion Therapy For Migraine Pain.”
RCCA: “Infusion Therapy FAQs For Patients In New Jersey, Connecticut, Maryland, And Washington, DC.”
Barrow Neurological Institute: “Dihydroergotamine Infusion.”
Mayo Clinic: “Electrocardiogram (ECG or EKG).”
Journal of Pain Research: “Updated Evaluation of IV Dihydroergotamine (DHE) for Refractory Migraine: Patient Selection and Special Considerations.”
