Who is Nerivio intended for?
Nerivio is indicated for acute and/or preventive treatment of migraine with or without aura in patients 12 years of age or older. It is a prescription use, self-administered device for use in the home environment either at the onset of migraine headache or aura for acute treatment, or every other day for preventive treatment.
The device should not be used by people with uncontrolled epilepsy and should not be used by people with an active implantable medical device, such as a pacemaker, hearing aid implant, or any implanted electronic device.
The device should only be applied on the upper arm over dry, healthy skin with normal physical sensation and without any metallic implants or in proximity to cancerous lesions.
When should I use the Nerivio?
Nerivio can be used for both acute and preventative treatments.
Acute Treatment – Treating A Migraine Attack
- When needed
- 45 minutes treatment
Use Nerivio as often as needed to treat migraine attacks. For best treatment results, begin treatment as early as possible during a migraine attack.
Preventative Treatment – Treating for Migraine Prevention
- Every other day
- 45 minutes treatment
For migraine prevention therapy, treatment should be performed every other day. Treatments can be performed at any time during the day; the most important thing is to pick a time that is convenient for you and stick to it. The Nerivio app offers treatment reminders, so you never miss a treatment.
Combining Acute and Preventative Treatments
Nerivio can be used to prevent migraines and to treat migraine attacks as follows: use Nerivio every other day to prevent migraine and as needed to treat migraine attacks.
For example, if you choose to perform a preventative treatment every Monday, Wednesday, Friday, and Saturday and:
- If you have a migraine attack on one of the days in which you do not plan to perform preventative treatments (e.g., Sunday) – conduct a 45-minute treatment when your migraine attack starts. Then continue with your preventative treatment on Monday, Wednesday, Friday, and Saturday as usual.
- If you have a migraine attack on one of the days in which you are planned to perform a preventative treatment (e.g., Monday) – you can do one of the two: if you already preformed your preventive treatment and then had a migraine strike, you can perform another, acute treatment. There is no limit to the number of treatments per day you can perform. If you haven’t performed your preventive treatment yet, you can combine the treatments into one treatment (that means, perform an acute treatment which will also serve as your usual preventative treatment). In either case, continue with your preventative treatment on Wednesday, Friday, and Saturday of this week as usual.
Can I use Nerivio if my migraine has started over an hour ago?
For an acute/abortive treatment, Nerivio can be used to treat your migraines at any time. Our clinical data show that Nerivio is more effective when used right when the symptoms start, therefore it is recommended to start treatments with Nerivio as early as possible and within 60 minutes of the onset of aura or migraine headache.
Nerivio can also be used for additional treatment sessions if the headache is not relieved or if it reoccurs.
In addition, Nerivio can be used for preventative treatment, see the FAQ “When should I use the Nerivio?”
Where can I buy the Nerivio?
Nerivio is available with a prescription at specialty pharmacies* as well as with our select Telemedicine partners. To obtain a Nerivio prescription please visit www.nerivio.com/get-nerivio/, follow the instructions and choose your preferred method for getting a prescription.
*Participating specialty pharmacies are subject to change without notice.
I have a prescription for Nerivio. How do I order?
Your healthcare provider will send your prescription to the specialty pharmacy. The special pharmacy will call you to verify your address and form of payment. If you do not hear from the pharmacy within 24 hours, please call the Nerivio Cares Support Team at 1-866-637-4846 Mon-Fri, 8:00 am – 8:00 pm.
How do I connect the Nerivio device to the app?
For guided assistance you may use in-app on-boarding help located at bottom menu
in ‘More’->’Nerivio device’->’Connect a new Nerivio device’. To connect your Nerivio to the app, you must enable Bluetooth on your smartphone. If you are using an Android phone, location access should be allowed, and location services should be turned on. The app will request you to allow these permissions.
To connect a new Nerivio device to the app, turn on the device (a slow flashing green light indicates the device is on) and press ‘Connect Nerivio’ in the app. The first time you connect the Nerivio device to the app, it should be in no more than 1 inch away from your smartphone. Each device can only be associated with one user account.
If you have already connected the app to a specific Nerivio device, an automatic connection will be established once the device is turned on and the app is opened.
Should I use Nerivio on the same side of my headache?
Nerivio can be used on either arm, regardless of the side of the headache.
How do I turn off Nerivio?
Nerivio will turn off automatically and has the following shut off features:
- The first time the device is turned on to pair and set up, the device will shut off automatically after 10 minutes.
- For all subsequent treatments, the device will give you 3 minutes to start the treatment and if not started, shuts off afterwards.
- If you pause the device during a treatment, the device will automatically shut off after 5 minutes if treatment is not restarted. Up to 3 treatment pauses can be used to ensure undisturbed treatment.
- At the end of any treatment the device will automatically turn off after one minute.
These built-in timers will not impact the device’s ability to provide 18 (eighteen) 45-minute treatments.
What is the armband for and how do I use it?
The armband should be wrapped around the device on your arm to improve the contact between the device and your skin. During your first use, you will need to adjust the armband to your size. There are 4 sizes you can choose from (S, M, L, XL). Use the extension for L and XL sizes. If the S size is still too loose to use, please contact Nerivio Cares at 1-866-637-4846 to have an XS armband sent to you. If the XL size is not large enough to use, please contact Nerivio Cares at 1-866-637-4846 to have an additional extension sent to you.
At what intensity should I treat my migraine headaches?
For the best results with Nerivio, it is important to find the treatment intensity that is right for you. With each use, set the Nerivio intensity so that it feels strong but comfortable for a 45-minute session.
The intensity can be adjusted in the app by tapping the ‘+’ and ‘-‘ buttons. Slowly increase the intensity to a point of discomfort and then decrease it by 1%-2%. In clinical trials, intensities lower than 20% were found to be less effective.
There is no need to readjust the intensity during treatment, but if the stimulation sensation on your arm feels weak, you may increase it a little to bring it back to feel strong but not painful.
What does the treatment feel like?
The device transmits electrical pulses. You will need to set the treatment intensity level by increasing it to the highest level that feels strong yet comfortable and painless. You may feel a strong sensation at first, but it will typically fade to a comfortable level after a couple of seconds. If the sensation is uncomfortable or painful, you should decrease the intensity. During the treatment you might experience a temporary sensation of warmth, local tingling, numbness in the arm, pain in the arm, or redness of the skin, which should disappear shortly after the end of the treatment. If you experience hand numbness and/or muscle twitching, try changing the location of the device on the arm.
Can I perform treatments without an internet connection?
Yes, treatments with Nerivio can be performed without an internet connection and do not require Wi-Fi or mobile data. An internet connection is only needed when you sign-up for or sign-in to the app. You should stay signed into the app when closing the app after a treatment, therefore internet will not be required for successive treatments.
The stimulation is not felt. What should I do?
Make sure that the protective film was removed from the electrodes, that the device and the app are connected, and that the treatment has started and has not been stopped or paused. Set the treatment intensity level so it feels strong yet comfortable and painless by touching the ‘+’ button in the app. If the stimulation is still unfelt, it is possible that the electrodes are losing adhesion strength. With the device turned off, use your finger to gently rub one or two drops of water onto the gel surface of the electrodes to improve their adhesion. If the adhesive surface of the electrodes is damaged, you should replace the device.
How many treatments can I perform with the Nerivio?
The device is good for 18 (eighteen) 45-minute treatments, and once those treatments are completed, the device should be disposed according to the instructions.
Theranica has a recycling program, see “How can I recycle my Nerivio device?”
To minimize moisture loss, when unused, the electrodes should be covered with the provided protective film and the device should be stored in its original package or in the travel bag. Also, every four treatments, rub the electrodes with your finger using a drop of water to improve their adhesiveness.
Can I use multiple Nerivio devices with the same user account?
Yes! The Nerivio app supports multiple Nerivio devices used by the same user. You can use them with the same smartphone or different ones. This is how this is done:
- Connect your first Nerivio to the app. The app is now paired with that device and you can control it using the app.
- You can connect a different device using the app with the same user using the “Connect” button on the treatment screen. Note that you can only connect to one device at a time so make sure only one device is turned on and that no treatment is in progress.
- You can have one Nerivio at home, another at work, and another to carry with you, if you so choose.
- Note that using the same Nerivio device with different user accounts will not work.
Will my information be shared?
Your privacy is very important to us, and your personal information is stored securely. Anonymous data may be used for scientific publications, reports and marketing. Your personal information, however, will never be shared without your consent.
You can share your information with your healthcare provider and loved ones by exporting your diary, and sending it via email or social apps.
What are the minimal smartphone requirements for the app?
The Nerivio app requires:
- At least 4.7 inches multi-touchscreen with at least 720x 1280 pixels resolution
- CPU of 1GHz or faster, internal memory of 2GB or more, and internal storage of at least 16GB
- Connectivity capabilities of BT4.0 or above
- Supported operating systems – iOS version 14 or newer and Android version 9 or newer.
How can I recycle my Nerivio device?
Theranica promotes and encourages recycling. We provide a prepaid envelope to send used devices for recycling. Contact us at firstname.lastname@example.org and provide us your name, mailing address, phone number, and how many devices you have to recycle. Please write in the email subject line: “Recycling request and we will send you a prepaid envelope.
Where can I download the Nerivio user manual?
Here you can download and print the user manual (version 2.9, November 2023). The user manual is in English and is applicable for Nerivio iOS app software version 188.8.131.52 and Nerivio Android app software version 184.108.40.206. Here is the quick start guide. You can also watch important instructions for effective treatment here.
Is there any latex in Nerivio?
No. None of the materials we use contain latex.
Does Nerivio provide disease management tools?
Yes, Nerivio provides a built-in Daily Headache Diary, to track of your headaches, associated symptoms, prodromal symptoms, and treatments. It is recommended to fill out the Daily Headache Diary every day, including on non-headache days, to ensure that you experience the full benefit of the best disease management tools. You may export the diary and share it with your healthcare provider and loved ones.
What is the “GIER UP!” button?
The Nerivio app provides a unique audio-visual feature for behavioral therapy and education, called “Guided Imagery, Education and Relaxation (GIER)”. This feature is designed for optional use in conjunction with Nerivio’s Remote Electrical Neuromodulation (REN) treatments. Research shows that using the GIER behavioral therapy may increases the chances of migraine relief, beyond that of the Nerivio treatment alone. You can use this GIER during either acute treatments and/or preventive treatments.
What is the GIER behavioral therapy? Where can I find it?
The GIER is “Guided Imagery, Education, and Relaxation” behavioral therapy. You can find the GIER in the upper right-hand corner of the treatment screen when a treatment is running, after setting your intensity and filling out the diary questions. Note: you can only access the GIER during a treatment.
How do I refill my Nerivio device?
The easiest way to refill your device is by using the in-app refill button. You can find it in the upper left-hand corner of the treatment screen. Otherwise, you can call your pharmacy and request a refill. If you are uncertain who to call, reach out to Nerivio Cares at 866-637-4846 and they will assist you.
Is Nerivio a TENS unit?
Nerivio is not a TENS unit. Nerivio and TENS units use different mechanism of actions, based on different electrical pulses and different stimulation sites.
Nerivio’s remote electrical neurostimulation (REN) mechanism is specifically designed to activate conditioned pain modulation, in which stimulation in the upper arm activates nerve endings that in turn activate a natural pain-relieving process in the brainstem, causing a global effect of pain inhibition that affects the original source of migraine pain in the head.
This differs from the mechanism of TENS units, which stimulate local nerves and compete with local pain fibers to block them from working (a mechanism termed gate theory), and thus must be applied at the same location of the pain (i.e., the head, during a migraine attack).
Does it really work?
Yes, our studies with acute treatment of migraine show that 66.7% of people experience pain relief with Nerivio at two hours post-treatment, and 37.4% of people achieve pain freedom at two hours post-treatment. Our studies with preventive treatment of migraine show a mean reduction of 4.0 migraine days per month after two months of preventive treatment. For more details on our clinical studies, please visit the clinical trials page.
Can you recommend a healthcare provider to prescribe Nerivio?
There are several ways to receive a Nerivio prescription—choose what suits you:
- Request a prescription online, via our Telemedicine partner
- Request a prescription from your healthcare provider
Please follow this link to choose the option you prefer.
If you are a Veterans Affairs patient please visit our Veterans page.
Is Nerivio covered by insurance?
Nerivio is eligible for insurance coverage! Insurance coverage differs by individual; it is best to call Nerivio Cares so we can discuss your unique circumstances. Call Nerivio Cares Support team at 1-866-637-4846 Mon-Fri, 8:00 am – 8:00 pm to learn more.
Is Nerivio for people with chronic migraine?
Yes. Nerivio, a prescription use, self-administered device for use at the onset of migraine headache or aura, or every-other-day for preventive treatment, for episodic and chronic migraine with or without aura in patients 12 years of age or older.