If you feel a migraine headache coming on, you probably take an over-the-counter pain reliever or abortive treatment. But what happens if these medications stop working? Your doctor may recommend switching to migraine infusion therapy to help.

MyMigraineTeam members have reached out to others to ask about their experiences with infusion therapy. “I’ve had migraines for 10 years and they’re getting worse. Nothing works for more than a month. The infusions they’re talking about are once every three months intravenously (through IV). Has anyone tried them?”

If your regular migraine medications aren’t working as well as they should, you may be a candidate for infusion therapy. The U.S. Food and Drug Administration (FDA) has approved several infusion treatment options to help those living with migraine.

In this article, we’ll discuss what infusion therapy is and how it works to offer migraine relief. We’ll cover specific information about FDA-approved treatments and who to talk to if you’re interested in trying them.

1. Infusion Therapy Injects Medications Directly Into Your Veins

IV infusions allow health care providers to give medications directly into the bloodstream. You’ll need to visit an outpatient infusion center or your doctor’s office to receive your treatment. If you’re in the emergency room (ER) or hospital for a severe migraine attack, your doctor may choose to give an IV treatment there.

Your nurse will use a needle to place a small, thin tube known as a cannula into a vein. You’ll most likely have the IV placed in your arm or the back of your hand. The nurse will then give your medications in an IV drip over several minutes to hours. Some people like to bring a book or activity to keep them occupied during the infusion.

Throughout your treatment, your nurse will monitor how you’re feeling and watch for any possible side effects. Possible side effects depend on the medication being infused. If you experience swelling of the face, mouth, or throat; hives; or difficulty breathing, this may mean that you are experiencing an allergic or infusion-related reaction and should seek medical attention immediately.

Once the infusion is completed, the health care provider will remove the catheter from your arm or hand and place a bandage over the injection site.

If you received treatment in an outpatient infusion center, you get to go home once your infusion is done. If you’ve been admitted to the hospital, your doctor may choose to keep you for a few days to continue treatment and monitor your symptoms.

2. Eptinezumab Prevents Migraine Headaches From Occurring

Eptinezumab-jjmr (Vyepti) is an FDA-approved treatment for preventing migraine headaches before they start. It belongs to a class of medications known as calcitonin gene-related peptide (CGRP) inhibitors. During migraine attacks, CGRP widens the brain’s blood vessels and triggers inflammation. Eptinezumab works by blocking the CGRP protein to prevent migraine attacks from developing.

Eptinezumab is a monoclonal antibody drug or biologic made from lab-engineered proteins. Biologics need to be injected — if you were to take a biologic by mouth, your stomach would digest the proteins before they have a chance to work.

You’ll visit an outpatient infusion clinic for your treatment. Your nurse will give your eptinezumab infusion over 30 minutes at the infusion center or doctor’s office. Possible side effects of eptinezumab infusions are nasal congestion and sore throat. Infusions are given once every three months, meaning you’ll only need four treatments per year.

3. DHE Is Given as an Abortive Treatment To Stop Migraine Attacks

Dihydroergotamine (DHE) — sold as D.H.E. 45 — is another infusion therapy doctors use to treat severe migraine symptoms. DHE works by narrowing the blood vessels responsible for the throbbing pain associated with migraine. It also blocks the brain from releasing CGRP protein.

Originally approved by the FDA in 1946, this medication has long been used to treat severe pain from migraine and cluster headaches already in progress. MedlinePlus notes that it shouldn’t be used to treat nonmigraine headaches nor to prevent migraine attacks from occurring.

Doctors typically prescribe DHE infusions for people who visit the ER when their migraine symptoms don’t improve with other treatments. You’ll receive an infusion every eight hours for one to three days. Possible side effects of DHE infusions include upset stomach, dizziness, and tiredness.

4. Studies Show Infusion Therapy Works for Treating and Preventing Migraine Attacks

The FDA approved eptinezumab based on two clinical trials. One study followed people with chronic migraine (at least 15 migraine days per month) — and the other followed people with episodic migraine (up to 14 migraine days per month). In both studies, participants received either eptinezumab or a placebo (inactive drug). The researchers reported that eptinezumab treatment reduced the number of monthly migraine days for people with chronic and episodic migraine.

MyMigraineTeam members have turned to others to ask about their experiences with migraine infusion treatments. One member asked another, “How many headaches did you have when you did the infusion?” They replied, “About 15 per month, sometimes more. Now it’s down to about two or three a month.”

Another shared their experience with their medication, “I had my infusion about two weeks ago. It’s almost completely taken away all my migraine pain. I’m feeling ‘normal’ again.”

5. Infusion Therapy Is Different From Other Migraine Treatments

Fortunately, there are several different migraine treatments available these days. Many work similarly to infused therapies to relieve your symptoms and prevent migraine headaches.

Gepants are a class of medications that, like eptinezumab, block CGRP. However, gepants are taken by mouth rather than IV infusion. Examples include rimegepant (Nurtec ODT), ubrogepant (Ubrelvy), and zavegepant (Zavzpret).

Oral medications are taken more regularly than infusions. Rimegepant is taken every other day to prevent migraine attacks, and it can also be taken to treat a migraine attack at the first signs of one starting. Ubrogepant is taken as a rescue treatment to stop migraine attacks as soon as they start. Zavegepant, available as a nasal spray, is also used for treating migraine attacks after they’ve begun.

Some migraine medications are given as injections rather than infusions. They’re injected subcutaneously, meaning underneath the skin. Depending on the type of migraine you have, you may need injections once every one or three months. Examples include:

• Erenumab-aooe (Aimovig)
• Fremanezumab-vfrm (Ajovy)
• Galcanezumab-gnlm (Emgality)

These injectable medications also block the effects of CGRP to treat and prevent migraine headaches.

If you’re admitted to the hospital, you may receive other therapies along with migraine medication. Dehydration can trigger migraine headaches, so you’ll likely get IV fluids. Electrolytes like sodium and potassium can also boost hydration if needed. IV fluids don’t contain any medications, but they may make you feel better while in the hospital.

6. You Can Talk to Your Doctor About Migraine Infusion Therapy

If you’re still experiencing frequent migraine attacks on your current treatment plan, make an appointment with your doctor or neurologist (brain specialist). They’ll explain your treatment options, which can include infusion therapy. You may have to try other medications first before trying a preventative infusion therapy like eptinezumab.

Overall, it’s important to work closely with your doctor to find which treatments work best for you. Finding the right combination of medications can take time, but it can help improve your overall quality of life.

Talk With Others Who Understand

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 81,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

Have you had infusion therapy to treat migraine? Was it effective? Share your experience in the comments below, or start a conversation by posting on your Activities page.