Ubrelvy...What is it and has anyone tried it?

[jost]

What are all these new drugs and do they work with cluster headaches, migraines or both? It seems as if the triptans were the wonder drugs for years and suddenly there are all these other options. Now there's Ubrevly and like Emgality and Ajovy there are no clear answers for the average person. Are they all chemically related like the triptans? Has anyone unraveled the enigma?

[Luis]

I think all of those are cgrp antagonist. They bind to pain receptors and make you not feel the pain of the headache. Emgality supposed to prevent headaches as well. 

[CHfather]

As I understand it, Ubrelvy is being marketed as a migraine abortive.  I might have missed it, but I haven't seen anything about Ubrelvy for CH.  It seems to slow-acting to me (it's a pill).  The others are preventives.  They all address calcitonin gene-related peptides (CGRP), but in different ways.  As I understand it, for example, the abortives are going to be small-molecule concoctions, whereas the preventives are large molecules.  Also, they are administered in different ways.  Most are injected, but Ubrelvy is a tablet.  This article covers the bases: https://www.practicalpainmanagement.com/pain/headache/new-frontier-migraine-management-inside-cgrp-inhibitors-migraine-prevention  A competitor to Ubrelvy is supposed to be introduced this year.  

Emgality results of people reporting here seem to be mixed, but I wouldn't take that to mean anything broader.  

[jost]

With CH an abortive needs to be faster acting then a pill unless you catch it very, very early in the game. It doesn't sound as if Ubrelvy would be any better than a triptan in that sense.

[xxx]

If used properly with hyperventilation, oxygen inhalation therapy is nearly as fast as subcutaneous triptan injections.  It has no adverse side effects and again using the procedure of hyperventilating with room air at forced vital capacity tidal volumes for 30 seconds followed immediately by inhaling a lungful of 100% oxygen and holding it for 30 seconds then repeating this sequence until the CH pain is completely gone usually takes an average of seven cycles - 7 minutes consuming less than 30 liters of oxygen , ~5 cents worth of oxygen gas/abort.

[jost]

How are people getting oxygen? The doctors around here are squeamish about prescribing it. Why is that?

[CHfather]

1 hour ago, Jost said:

How are people getting oxygen? The doctors around here are squeamish about prescribing it. Why is that?

If they just look in whatever resource they use for prescribing, they will see that oxygen is listed as the #1 abortive (along with injectable sumatriptan). So either they don't care enough to look, or if they do look, their squeamishness is probably the result of not having CH patients and therefore either (a) not knowing how to prescribe it, and/or (b) never having had a patient who used high-flow O2 and not having any idea about how it is used, what could go wrong, etc.  That is, either they don't really care or they are protecting their own ignorance at your expense.  Maybe there are other explanations, but I haven't been able to think of them.  I think the BS they sometimes pass on -- "I could prescribe it but why bother since your insurance won't cover it anyway?" -- is just part of that self-protection.