Cost, Types, and Insights on Migraine Injection Devices
News Article: Comparing Migraine Self-Injection Pens: Imitrex, D.H.E. 45, and Emgality
A comparison of three migraine self-injection pens, Imitrex (sumatriptan), D.H.E. 45 (dihydroergotamine), and Emgality (galcanezumab), reveals differences in their most common and serious side effects, as well as their mechanisms and uses.
Imitrex (Sumatriptan)
Sumatriptan, sold under the brand name Imitrex, is a migraine medication used for acute treatment. Its most common side effects include paresthesia (tingling), warm/cold sensations, pain or pressure sensations including chest pain, neurological symptoms like vertigo, malaise/fatigue, and sleep disturbances. These occur in roughly 2-8% of patients [1]. More serious but less common risks include cardiac events (coronary vasospasm, myocardial infarction), serotonin syndrome, stroke, and seizures [1].
D.H.E. 45 (Dihydroergotamine)
Dihydroergotamine, marketed as D.H.E. 45, is another medication used for acute migraine treatment. Its side effects mainly relate to its vasoconstrictive action, with common issues including nausea and vomiting. Because DHE constricts blood vessels more prolongedly than triptans, side effects can relate to vascular constriction and central nervous system effects [2]. D.H.E. 45 can also cause gastrointestinal effects and rarely, serious cardiovascular effects similar to triptans, but detailed incidence data were not available in the results [2].
Emgality (Galcanezumab)
Emgality, a CGRP monoclonal antibody, is a preventive medication. Its most common side effects are injection site reactions such as redness, swelling, itching, or pain, which typically resolve within a few days [3]. Other side effects include mild constipation (about 3% of patients) and fatigue, especially in the initial treatment weeks [3]. Severe allergic reactions are rare but possible and require immediate medical attention [3].
In comparison, systemic side effects are more frequent with Imitrex and D.H.E. 45 due to their mechanisms involving vascular constriction and central nervous system effects, whereas Emgality, a monoclonal antibody targeting CGRP (a substance involved in migraines), mainly causes local injection site reactions and mild systemic symptoms.
Pricing
Retail prices for the three self-injection pens are $438 for Imitrex, $12,295 for Emgality, and $665 for D.H.E. 45 [4]. It is worth noting that most insurance companies cover the cost of a migraine self-injection pen with a recommendation from a doctor.
Usage and Administration
Migraine self-injection pens are used for both acute treatment and preventive treatment of migraines. An injection of D.H.E. 45 usually prevents migraine headaches from returning within 24 hours. Emgality is a preventive medication that a person takes once per month, suggesting that the effects last 1 month. Imitrex should be taken at the first sign of a migraine attack, with a maximum single dose of 6 milligrams and no more than 12 milligrams within 24 hours.
Considerations
A person considering using a migraine self-injection pen should speak with a doctor about the different options available. D.H.E. 45 should be administered as a doctor prescribes, with no second dose within 6 hours and no more than a 6 milliliter dosage within a week. Emgality may cause angioedema and anaphylaxis, a severe and potentially life-threatening allergic reaction.
Summary Table
| Medication | Most Common Side Effects | Serious Side Effects | |---------------------|------------------------------------------|------------------------------------| | Imitrex (Sumatriptan) | Paresthesia, pressure/chest pain, vertigo, fatigue, sleep disturbance | Cardiac events (MI, vasospasm), serotonin syndrome, stroke, seizures | | D.H.E. 45 (Dihydroergotamine) | Nausea, vasoconstriction effects (not fully detailed) | Cardiovascular risks similar to triptans (rare) | | Emgality (Galcanezumab) | Injection site reactions, constipation (~3%), fatigue | Severe allergic reactions (rare) |
This reflects common and serious side effects based on current clinical data and prescribing information [1][2][3].
[1] Mayo Clinic. (n.d.). Sumatriptan. Retrieved from https://www.mayoclinic.org/drugs-supplements/sumatriptan-oral-tablet/description/drg-20073087
[2] Mayo Clinic. (n.d.). Dihydroergotamine. Retrieved from https://www.mayoclinic.org/drugs-supplements/dihydroergotamine-oral-tablet/description/drg-20067373
[3] Emgality. (n.d.). Emgality Prescribing Information. Retrieved from https://www.emgality.com/docs/emgality-pi.pdf
[4] GoodRx. (2023). Imitrex, Dihydroergotamine Mesylate, and Emgality. Retrieved from https://www.goodrx.com/migraine-medications/price-comparison
- In the realm of health-and-wellness, science continues to explore new methods for pain management, such as the use of migraine self-injection pens, which include Imitrex (sumatriptan), D.H.E. 45 (dihydroergotamine), and Emgality (galcanezumab).
- Migraine, a prevalent neurological disorder, can cause severe headache and other symptoms, and these self-injection pens serve as potential treatment options in emergency and ongoing pain management.
- Fitness-and-exercise, along with a balanced diet and proper rest, are essential components of health and wellness. However, for those suffering from migraines, these self-injection pens may provide temporary relief, enabling individuals to maintain their daily routines.
- While each of these self-injection pens comes with its unique side effects, it is crucial to understand that Emgality, a preventive medication, mainly causes local injection site reactions and mild systemic symptoms, unlike Imitrex and D.H.E. 45, which have more systemic side effects due to their mechanisms involving vascular constriction and central nervous system effects.
- Healthcare providers and patients should carefully consider the costs, benefits, and risks associated with each of these medical-conditions treatments, as retail prices vary, and insurance coverage can help offset the costs in many cases.
