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New medication approved for acute treatment of migraine ― Reyvow™ (lasmiditan) tablets

by Mary McNitt | Nov 11, 2019

The U.S. Food and Drug Administration (FDA) approved a new medication to treat acute (active but short-term) migraine with or without aura (often described as a visual disturbance such as flashing lights) in adults. This approval granted Eli Lilly and Company (Lilly) to market Reyvow, which according to Lilly, is the first and only FDA-approved serotonin 1F receptor agonist medication in this new class of acute migraine treatments. Reyvow will not be indicated to prevent migraine headaches as with many treatments on the market.

Availability
Reyvow will be available in 50 mg and 100 mg oral tablets and is expected to be released to retail pharmacies in January 2020, according to Lilly. This release is pending a determination by the Drug Enforcement Administration (DEA) of this medication’s abuse potential. As with all medications affecting the central nervous system, Reyvow was studied for potential abuse and its DEA classification is yet to be determined.

Prevention vs. acute treatment
Medications used to treat an acute migraine attack are not the same as those medications used to prevent migraine headaches. For acute migraine, medications should be taken at the onset of a migraine and used as needed, at the lowest effective dose, for the shortest period of time to avoid medication overuse headache.

The main classes of medications available to treat acute migraine are those that narrow blood vessels (triptans, ergotamines) and relieve pain, such as non-opioid medications, including but not limited to naproxen sodium (Aleve®), ibuprofen (Advil®), acetaminophen (Tylenol®) and aspirin (Bayer®). Combination medications containing caffeine (e.g., Fioricet®) may be helpful in some cases.

Conversely, medications used to prevent migraine should be taken on a consistent basis in order to be effective and to reduce the number of acute migraine attacks. Like other disorders, treatment for migraine must be individualized and based on effectiveness, side effects and other medical conditions.

Impact on workers’ compensation
In our book of business, the top five most prescribed medications to treat acute migraine include three triptans and a combination medication containing caffeine - sumatriptan tablets (Imitrex®), butalbital/acetaminophen/caffeine tablets (Fioricet), butalbital/acetaminophen/caffeine capsules (Fioricet), rizatriptan tablets (Maxalt®) and eletriptan tablets (Relpax®).

Prior to a full review by the OWCA Pharmacy and Therapeutics (P&T) Committee, Reyvow will be excluded or require prior authorization on our standard formularies. To minimize over-prescribing and medication overuse headaches, quantities should be limited. For example, when the triptans (e.g., Imitrex, Maxalt, Relpax) are allowed on certain injury-based formularies, such as those involving head or cervical spine injuries, quantities are limited to up to 18 tablets/doses in 30 days.

To date, the cost has not been published. To learn more about Reyvow, click here.

If you have any questions, please contact your account manager, clinical liaison or our Clinical Services team at 1-877-275-7674 ext. 8612.


Sources:

  1. U.S. Food and Drug Administration (FDA). News Release. FDA approves new treatment for patients with migraine. October 11, 2019. Available at https://www.fda.gov/news-events/press-announcements/.
  2. Eli Lilly and Company. News Releases. Lilly's REYVOW (lasmiditan), The First and Only Medicine in a New Class of Acute Treatment for Migraine, Receives FDA Approval. October 11, 2019. Available at https://investor.lilly.com/news-releases/news-release-details/lillys-reyvowtm-lasmiditan-first-and-only-medicine-new-class.
  3. Reyvow [package insert]. Indianapolis, IN: Eli Lilly and Company. Available at http://pi.lilly.com/us/reyvow-uspi.pdf .


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New medication approved for acute treatment of migraine ― Reyvow™ (lasmiditan) tablets

by
Clinical Connection team
| Nov 11, 2019

The U.S. Food and Drug Administration (FDA) approved a new medication to treat acute (active but short-term) migraine with or without aura (often described as a visual disturbance such as flashing lights) in adults. This approval granted Eli Lilly and Company (Lilly) to market Reyvow, which according to Lilly, is the first and only FDA-approved serotonin 1F receptor agonist medication in this new class of acute migraine treatments. Reyvow will not be indicated to prevent migraine headaches as with many treatments on the market.

Availability
Reyvow will be available in 50 mg and 100 mg oral tablets and is expected to be released to retail pharmacies in January 2020, according to Lilly. This release is pending a determination by the Drug Enforcement Administration (DEA) of this medication’s abuse potential. As with all medications affecting the central nervous system, Reyvow was studied for potential abuse and its DEA classification is yet to be determined.

Prevention vs. acute treatment
Medications used to treat an acute migraine attack are not the same as those medications used to prevent migraine headaches. For acute migraine, medications should be taken at the onset of a migraine and used as needed, at the lowest effective dose, for the shortest period of time to avoid medication overuse headache.

The main classes of medications available to treat acute migraine are those that narrow blood vessels (triptans, ergotamines) and relieve pain, such as non-opioid medications, including but not limited to naproxen sodium (Aleve®), ibuprofen (Advil®), acetaminophen (Tylenol®) and aspirin (Bayer®). Combination medications containing caffeine (e.g., Fioricet®) may be helpful in some cases.

Conversely, medications used to prevent migraine should be taken on a consistent basis in order to be effective and to reduce the number of acute migraine attacks. Like other disorders, treatment for migraine must be individualized and based on effectiveness, side effects and other medical conditions.

Impact on workers’ compensation
In our book of business, the top five most prescribed medications to treat acute migraine include three triptans and a combination medication containing caffeine - sumatriptan tablets (Imitrex®), butalbital/acetaminophen/caffeine tablets (Fioricet), butalbital/acetaminophen/caffeine capsules (Fioricet), rizatriptan tablets (Maxalt®) and eletriptan tablets (Relpax®).

Prior to a full review by the OWCA Pharmacy and Therapeutics (P&T) Committee, Reyvow will be excluded or require prior authorization on our standard formularies. To minimize over-prescribing and medication overuse headaches, quantities should be limited. For example, when the triptans (e.g., Imitrex, Maxalt, Relpax) are allowed on certain injury-based formularies, such as those involving head or cervical spine injuries, quantities are limited to up to 18 tablets/doses in 30 days.

To date, the cost has not been published. To learn more about Reyvow, click here.

If you have any questions, please contact your account manager, clinical liaison or our Clinical Services team at 1-877-275-7674 ext. 8612.


Sources:

  1. U.S. Food and Drug Administration (FDA). News Release. FDA approves new treatment for patients with migraine. October 11, 2019. Available at https://www.fda.gov/news-events/press-announcements/.
  2. Eli Lilly and Company. News Releases. Lilly's REYVOW (lasmiditan), The First and Only Medicine in a New Class of Acute Treatment for Migraine, Receives FDA Approval. October 11, 2019. Available at https://investor.lilly.com/news-releases/news-release-details/lillys-reyvowtm-lasmiditan-first-and-only-medicine-new-class.
  3. Reyvow [package insert]. Indianapolis, IN: Eli Lilly and Company. Available at http://pi.lilly.com/us/reyvow-uspi.pdf .