How to Inject Aimovig: 8 Pharmacist Tips for Using This Migraine Medication Properly

Aimovig (erenumab-aooe) is a once-monthly injection used for migraine prevention in adults. Aimovig is a monoclonal antibody that belongs to a class of medications called calcitonin gene-related peptide (CGRP) receptor antagonists. It’s available in two doses: 70 mg and 140 mg. It comes as either a single-dose autoinjector and prefilled syringe.

Aimovig is convenient to use overall. But it’s important to learn how to use it properly. Here, we’ll discuss how to inject Aimovig.

1. Preparing for your Aimovig injection

To prepare for your Aimovig injection, you’ll first need to take the medication out of the refrigerator. Let it sit at room temperature (68°F to 77°F) for at least 30 minutes. This is done to help lessen discomfort from the injection. Cold injections tend to hurt more.

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Inspect your Aimovig device next. It should be a clear-and-colorless to light-yellow liquid. If it’s discolored, cloudy, or there are any flakes or particles in the solution, don’t use it. Air bubbles are OK, though.

Make sure you have the right supplies to administer the injection, too. You’ll need:

• A clean, flat, well-lit surface

• Alcohol wipe

• Cotton ball or gauze pad

• Bandages

• Sharps container

2. Choosing the best Aimovig injection site

You should always inject Aimovig under the skin (subcutaneously). But you can do this in several parts of your body. The main Aimovig injection sites are the abdomen (at least 2 inches from your belly button), front of the thigh, or back of the upper arm.

If you choose to inject in the back of your upper arm, have someone help you. This is due to the awkward angle of trying to do it yourself. Also avoid areas where the skin is hard, bruised, or tender.

3. Administering the injection

Once you’re ready to give the injection, wash your hands with soap and water. Then, swab your preferred injection site with an alcohol wipe. Let the area dry naturally and avoid touching it. 

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The next step depends on which version of Aimovig you’re prescribed.

Option 1: Aimovig autoinjector

Pick up the autoinjector and hold it so you can see the medication window. Then, find the cap on the end of the autoinjector. The cap will be either white or orange, depending on if you’re using the 70 mg or 140 mg pen. Pull this cap straight off. You may have to pull somewhat hard.

Once the cap is removed, the safety guard (which contains the needle) will be exposed. The safety guard will be dark green on the 70 mg pen and yellow on the 140 mg pen.

Stretch or pinch the skin at the injection site to create a firm surface for the injection. Place the safety guard against the skin and hold the device at a 90° angle against the injection site. Make sure you’re still able to see the medication window.

Push the autoinjector down against the skin until the safety guard stops moving. Once the safety guard is fully pushed in, it will unlock the start button at the opposite end of the device. The start button is purple on the 70 mg pen and gray on the 140 mg pen.

While still pressing the autoinjector against the skin, push the start button. This will begin the injection. At this point, you may hear or feel a click and the medication window will start to turn yellow. It’s OK to now take your finger off of the start button.

Continue to push the pen against the skin and watch to make sure the medication window turns fully yellow. This means the injection is complete. This process can take up to 15 seconds.

Pull the autoinjector away from your body. The safety guard will cover the needle. Dispose of the autoinjector and cap right away in a sharps container. Never place Aimovig in your household trash. Aimovig is a single-dose pen that shouldn’t be reused.

Option 2: Aimovig prefilled syringe

Remove the Aimovig syringe from the carton. Grab it by its barrel (the middle of the syringe) to lift it from the tray. Make sure you aren’t touching the plunger rod or gray needle cap while you do this.

Continue to hold the syringe by its barrel and pull the gray needle cap straight off and away from you. Throw the needle cap away in a sharps container.

Pinch an area of skin about 2 inches wide to create a firm surface to give your injection. Then, insert the syringe into the pinched skin at a 45° to 90° angle. Keep this skin pinched until you’ve finished the injection.

Once the needle and syringe are in the skin, place a finger on the plunger rod and press the rod down slowly until it stops moving. Take your finger off of the plunger rod and pull the syringe away from your body.

Throw away the Aimovig syringe in a sharps container. Aimovig is a single-dose syringe and should never be reused.

4. Post-injection care advice

When you remove the autoinjector or prefilled syringe from the injection site, check to see if all of the medication has been injected. If the window hasn’t fully turned yellow or it looks like the medication is still coming out (autoinjector), you may not have received a full dose. If it looks like there is still medication in the syringe barrel (prefilled syringe) you may not have received a full dose. If this happens, contact your prescriber for what to do next.

Inspect the injection site next. If you’re bleeding, hold a cotton ball or gauze pad against the injection site. Secure it with a bandage if you need to. Don’t rub the injection site. 

Temporary discomfort at the injection site is normal, but if it persists after a few days, contact a healthcare professional.

5. Local and systemic Aimovig side effects to look out for

Aimovig is generally well tolerated. But like with most medications, it can have side effects. Some are confined to the injection site, but others can be systemic. This means they affect multiple areas of your body.

Injection site reactions are most common. They typically consist of redness, swelling, and pain where you administered the medication. If these symptoms are bothersome, a warm compress, ice pack, or over-the-counter (OTC) pain relievers — such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) — may help.

Constipation is another relatively common side effect. If you experience mild constipation, you can try managing it at home by increasing your fluid intake, consuming more fiber, and exercising. You can also ask a healthcare professional about OTC medications like stool softeners or laxatives, if needed.

If constipation persists or gets worse, contact a healthcare professional right away. Severe constipation has been reported by some people taking Aimovig, most often after their first dose.

Some people have also reported high blood pressure after using Aimovig. Most who experienced high blood pressure already had chronic high blood pressure or had risk factors for developing it. High blood pressure can happen at any time during treatment, but it’s more likely to happen after the first dose.

6. Aimovig storage tips

You should store Aimovig in the refrigerator between 36°F to 46°F. If you remove Aimovig from the fridge, you should keep it at room temperature (68°F to 77°F) and use it within 7 days. You shouldn’t put Aimovig back in the refrigerator once it’s reached room temperature. 

Always store Aimovig in its original container to protect it from light. You should never freeze Aimovig or shake it.

7. Spread out your Aimovig dosages by several weeks

Aimovig is a once-monthly injection. Its effects are long-acting, similar to migraine medications like Emgality (galcanezumab-gnlm) and Ajovy (fremanezumab-vfrm). Each of these injections should be used once a month. But depending on the dose, Ajovy can also be given once every 3 months. 

If you administer your injections too close together, you have a higher risk of side effects.

8. How to remember your Aimovig doses (and what to do if you miss one)

There are several tools that can help you to remember your Aimovig doses. You can use a medication reminder app or a journal, or write it in a physical calendar if you use one. You can even schedule your Aimovig doses on the same day as another monthly event — such as paying your bills — to help you remember them. If you have a friend who also uses Aimovig, or another monthly medication, you can schedule your dose on the same day to remind one another.

If you happen to miss your Aimovig dose, give your injection as soon as you remember. Moving forward, schedule your next Aimovig dose 1 month from that date.

How to save on Aimovig

There are ways to save on Aimovig, which is available as a reference (“brand name”) biologic. GoodRx can help you navigate between copay savings cards and patient assistance programs to save money on your prescription.

• Save with a copay savings card: If you have commercial insurance, you may be eligible to pay as little as $5 per month for Aimovig using a savings card from the manufacturer.

• Save with patient assistance programs: If you’re uninsured or underinsured, you may be eligible for Aimovig’s patient assistance program, which offers the medication for free.

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Written by:

Jenna Clayton, PharmD

Jenna Clayton, PharmD earned her Doctor of Pharmacy degree at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences in Buffalo, New York. Throughout her doctoral program, Jenna gained experience in a variety of pharmaceutical settings, including community, hospital, long-term care, and ambulatory care settings.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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