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New Drug Coming Early 2020: Reyvow

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After many years of waiting, a completely new type of migraine drug is projected to hit local pharmacies in the USA in only a few weeks.

Feel like you’ve heard that before? Of course you have. New medications and even new devices have been hitting the market at an unusual rate over the past couple of years. But yes – as the first paragraph stated – this is once again a new class of migraine medication, something that may help some people who haven’t found a good option in the past.

The new type of drug from Eli Lilly and Company is known as a 5-HT1F receptor agonist, and the drugs in this class are referred to as “ditans”. And there is something else that sets this drug apart from the crowd of the recent new drug approvals. It’s an abortive drug – something to be taken when a migraine attack hits. So this is not another preventative, which has been all the rage lately.

Reyvow, or lasmiditan (or LY573144), is a drug we started talking about in 2012, so it’s been quite the wait. Way back then, when there were more concerns about migraine drugs affecting the cardiovascular system, lasmiditan was considered unique because it didn’t seem to carry the same dangers. In fact, people with risk of cardiovascular disease were eventually included in clinical trials.

Clinical trials have shown effectiveness for some patients within 30 minutes, with the common 100mg or 200mg doses. Reyvow seems to alleviate not only pain, but also sensitivity to light and noise, and nausea.

Long term testing over a year also showed that there were no serious side effects (in particular cardiovascular issues). The most common side effect was some dizziness, and rarely some sleepiness. But remember, these are drugs you take when you are already having a migraine attack. And although a minority of patients did experience some dizziness, over the course of the year the side effects seemed to diminish.

However, as with many abortive migraine drugs, it is recommended that patients avoid driving for a few hours after taking Reyvow.

Preventative drugs may be taken at the same time as Reyvow.

The FDA is currently deciding how to classify Reyvow, and their decision is expected in January 2020. After that, Reyvow will be made available in the United States.

As with the other medications we’ve seen hitting the market recently, Reyvow is not a miracle drug. However, every new approach brings with it the potential that the drug will help patients who have never been helped before, patients who have been unable to take other drugs because of side effects or other health concerns, or patients who are simply not satisfied with their current meds.

So yes, the release of Reyvow is big news – and we wait to see how it will help many of our readers.

For more on Reyvow, visit Lilly’s website here.

Nausea / Vomiting and Migraine: 10 Facts

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Nausea / Vomiting and Migraine

  1. N/V: one of the most common symptoms of migraine.
  2. Childhood N/V disorders may be migraine or indicate future migraine.
  3. Nausea could be an early sign of migraine – hours before headache (if there is headache).
  4. There’s no nausea in occasional tension-type headache (TTH), but could be in more constant or chronic TTH.
  5. Typical treatment of migraine often fights N/V also (ie triptans, biofeedback).
  6. Many patients take suppositories, transdermal meds, etc. to avoid problems with pills that go through the digestive system.
  7. Some medications specifically fight N/V, such as metoclopramide, dimenhydrinate, and promethazine.
  8. Some supplements may treat/prevent N/V,such as feverfew and ginger.
  9. Talk to your doctor.  It can be dangerous to take multiple medications/supplements at the same time.
  10. Common sense: Stay hydrated, relax, and eat bland foods when you can.

For more, check out Migraine nausea, Nausea – still a Major Migraine Problem, and for specific general information on the headache disorders mentioned above, the 2nd Edition of The International Headache Classification.

Zofran for Migraine (fight nausea)

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One type of medication that we haven’t discussed much is Zofran for migraine, or ondansetron.  It’s not that unusual for a doctor to prescribe it, and we’ll see why in a moment.

Zofran is a common brand name, but ondansetron is also sold as Emeset, Emetron, Ondavell and others.

Originally used for nausea after and operation or chemotherapy, ondansetron is now much more widely used.  When it comes to migraine, Zofran is commonly prescribed to fight nausea.

Zofran may be taken by adults and children both, so it may be useful for children who tend to experience a lot of vomiting and nausea with migraine.  It works quickly, and usually has very minimal side effects.  In fact, it will not cause drowsiness like many anti-nausea drugs will.

When you have migraine, particularly migraine with nausea, you want something that works fast.  That’s why the "dispersible" versions – which dissolve in your mouth – are so popular.  A generic version is available at Drugstore.com (8mg being the common dosage for adults).

Ginger for Mary Ann’s migraine

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Truly, this website has some of the best visitors in cyberspace, and the ezine HeadWay has some of the best readers.  In January’s issue we talked about nausea, and many of you visited the HeadWay MailRoom with great feedback.  And you very graciously pointed out a glaring omission in my article – the use of ginger for nausea.  You didn’t call me names and demand an apology, instead you shared your experiences and some of the practical ways you’ve used ginger to make that migraine attack more bearable.  For example, Faith from the USA suggested Preggy Pops (available in the USA, the UK and Australia and wherever amazon.com ships).  Don’t worry, guys – you can buy Queasy Pops – doesn’t that sound more masculine?

To rub sea salt in my wound, I picked up the TIME magazine a few days ago which commented on a new study showing that ginger helped with post-operative nausea.  I don’t know how I missed it.  You must think I’ve been on a desert island all this time.

Anyway, you may have noticed a new page here – I’ve dedicated a whole article to the problem of nausea in migraine (and cluster and tension headache too).  Perhaps to redeem myself, I wrote a lot about ginger, but there’s lots more there.  This one is close to my heart, since I’ve had to deal with the worst of this symptom during migraine attacks.

So if you find yourself marooned with nausea, take the three minute migraine nausea tour.  You don’t have to be a millionaire to find solutions.

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