How Brekiya Works and How It’s Taken

Brekiya is a type of ergot medicine used to treat migraine attacks in adults. It works by attaching to serotonin receptors, which are docking sites on certain cells. This affects blood vessel and nerve signaling linked to migraine attacks.

Doctors prescribe Brekiya when a migraine attack begins and acute treatment is needed for migraine with or without aura in adults.

Brekiya is given as an injection under the skin using a single-dose autoinjector. The dose may be repeated, if needed, at one-hour intervals. With proper training, individuals may use the autoinjector at home.

Typical Dosing for Migraine

The recommended dose of Brekiya for acute migraine treatment is 1 milligram injected under the skin using a prefilled, single-dose disposable autoinjector. Brekiya is intended to be injected into the skin of the middle thigh.

The dose may be repeated as needed, up to 3 milligrams in 24 hours. Do not use more than 6 milligrams in one week.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

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Brekiya Side Effects

Brekiya can cause side effects. Some side effects have been reported in clinical studies and after the medicine became available for use. Reported side effects include:

• Dizziness
• Anxiety
• Dyspnea (shortness of breath)
• Flushing
• Diarrhea
• Rash
• Increased sweating

Serious Side Effects and Warnings

Brekiya can cause serious side effects that may require immediate medical attention. These include:

• Peripheral ischemia with strong CYP3A4 inhibitors — Dangerously reduced blood flow to the brain or arms, hands, legs, or feet can occur when Brekiya is taken with strong CYP3A4 inhibitors.
• Serious heart problems — These can include reduced blood flow to the heart, heart attack, and dangerous heart rhythm changes.
• Cerebrovascular adverse reactions — Stroke and other serious blood vessel problems in the brain can occur and may be fatal.
• Vasospasm-related problems — Sudden tightening of blood vessels can reduce blood flow to the heart, intestines, or limbs.
• Increased blood pressure — Blood pressure may rise significantly.
• Medication overuse headache — Headaches can worsen from using acute migraine medicines too often.
• Preterm labor — Brekiya may increase the risk of early labor during pregnancy.
• Fibrotic complications — Scarring can affect areas such as the lung lining or the space behind the abdomen, usually with prolonged daily use.
• Hypersensitivity reactions — Serious allergic reactions can occur, including in people with latex allergy, because the autoinjector contains dry natural rubber.

Get medical help right away if you think you are having a serious reaction.

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How To Save on Brekiya

Amneal Pharmaceuticals, the manufacturer of Brekiya, offers a Copay Program. Eligible people with commercial insurance may pay as little as $40 per carton.

The Copay Program offers automatic enrollment for qualified commercially insured people through participating specialty pharmacies, with no cards or coupons needed.

To learn more, visit the How To Get Brekiya page or contact the participating specialty pharmacies listed by the manufacturer: Sterling Specialty Pharmacy at 888-618-4126 or Walgreens Specialty Pharmacy at 888-282-5166.

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What To Know Before Taking Brekiya

Before starting Brekiya, your doctor may do a cardiovascular evaluation to check your heart health.

Tell your doctor if you have any allergies to dihydroergotamine mesylate, ergot alkaloids, latex, or any ingredients in Brekiya. Do not take Brekiya if you have had an allergic reaction to dihydroergotamine, ergot alkaloids, latex, or any ingredient in Brekiya.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not take Brekiya if you:

• Take a strong CYP3A4 inhibitor
• Have ischemic heart disease or coronary artery vasospasm, including Prinzmetal’s angina
• Have uncontrolled high blood pressure
• Have peripheral arterial disease
• Have sepsis
• Are following vascular surgery
• Have severe liver or kidney problems
• Have used a triptan or an ergotamine-containing or ergot-type medicine within the last 24 hours
• Take peripheral or central vasoconstrictors

Brekiya is also FDA-approved for the acute treatment of cluster headaches in adults.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Brekiya, talk with your doctor about the risks and benefits. Avoid use during pregnancy.

Do not breastfeed during treatment and for three days after your last dose. Pump and discard breast milk during this time.

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Community FAQs

These answers are fact-checked by our editorial staff.

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Learn More

On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.

Learn more about Brekiya and migraine care:

• Homepage — Brekiya
• Migraine and DHE: What It Is and When It’s Used — MyMigraineTeam
• Migraine and Medication Side Effects: What To Watch For — MyMigraineTeam
• Migraine Treatments and How They Work — MyMigraineTeam
• Dihydroergotamine (DHE) for Migraine Treatment — American Migraine Foundation

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