How to Inject Ajovy (Plus 4 More Pharmacist-Backed Tips for Successful Injections)

Ajovy (fremanezumab-vfrm) is an injectable medication that can help prevent migraines. It can be a convenient treatment option. Unlike oral migraine prevention medications, Ajovy is only used once a month or once every 3 months.

Knowing how to inject Ajovy correctly is crucial for making sure it works and helping to limit side effects. Below, you’ll find five tips for using Ajovy.

1. Where to inject Ajovy

Ajovy is a subcutaneous injection that’s injected beneath the skin. There are three areas on your body where you can inject Ajovy:

• Abdomen (stomach area): Choose an area at least 2 inches away from your belly button.

• Front of your thighs: Find an area at least 2 inches above your knee and 2 inches below your groin. Avoid using the inner or outer areas of the thigh.

• Back of your upper arms: Aim for the fleshy area in this location. This injection site is tricky to reach when self-injecting. But it may be an option if someone else is administering Ajovy for you.

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Depending on your Ajovy dosage, you’ll inject one dose (225 mg) once a month or 3 doses (675 mg) once every 3 months. The 3-month dosage option requires you to administer three separate injections. You can give all three injections in the same general body area — just not in the same spot.

Don’t inject Ajovy into skin areas that are red, tender, or bruised. And avoid injecting in areas that have tattoos, scars, or stretch marks.

2. How to inject Ajovy

Ajovy comes as an autoinjector pen and prefilled syringe. Each autoinjector or syringe contains one dose of medication and has a needle already attached. Below is a step-by-step guide on how to inject Ajovy autoinjectors and prefilled syringes.

Good to know: Place your Ajovy autoinjector(s) or syringe(s) at room temperature for about 30 minutes before you inject. This can help make the injection process more comfortable.

Gather your supplies

Before injecting Ajovy, collect your supplies. You’ll need:

• One Ajovy autoinjector or syringe (if you inject doses once a month)

• Three Ajovy autoinjectors or syringes (if you inject doses once every 3 months)

• Alcohol swabs

• Cotton balls or gauze pads

• Small bandages

• Needle disposal container

Clean the injection site

Wash your hands for at least 20 seconds with soap and water. If you don’t have access to soap and water, you can use an alcohol-based hand sanitizer.

Use an alcohol swab to clean the skin where you will be injecting Ajovy. Let your skin air-dry. Don’t blow on your skin to help it dry faster. This can introduce bacteria or other germs to the area you just cleaned.

If you administer 3 Ajovy injections every 3 months, use a different alcohol swab for each injection site. Using the same swab for multiple sites can transfer germs from one body area to another.

EXPERT PICKS: WHAT TO READ NEXT

• Compare options: Ajovy works by blocking a protein called calcitonin gene-related peptide (CGRP). Learn about other CGRP antagonists and the differences between them.

• What migraines feel like: Read firsthand accounts of living with chronic migraine and how people manage symptoms.

• Biologics for migraines: Ajovy is a type of biologic medication. See how biologics work for migraine prevention.

Inspect your autoinjector or syringe

Inspect each Ajovy autoinjector or syringe you’ll be using. Check that they aren’t expired. And make sure the medicine inside is clear or slightly yellow. Don’t use it if the liquid is discolored, cloudy, or contains particles.

You may notice small air bubbles. This is normal, and you shouldn’t try to remove them. Injecting Ajovy with these air bubbles won’t harm you.

Inject your dose (autoinjector)

The directions below are for Ajovy autoinjectors. You’ll need to repeat this process three times if you use Ajovy every 3 months.

• Remove the protective cap by pulling it straight off. This exposes a blue needle shield. Throw the cap away in your regular household trash.

• Place the autoinjector at a 90-degree angle against your injection site with the blue needle shield touching your skin. Position the autoinjector so you can see the medication viewing window.

• Firmly press down to push the needle into your skin. Hold it there until the injection is complete (about 30 seconds). You’ll hear two clicks: one when the injection starts and one when the plunger has moved across the medication viewing window. After you hear the second click, slowly count to 10 before removing the autoinjector from your skin.

• Once your injection is finished, lift straight up to remove the needle from your skin.

• Gently press (not rub) a cotton ball or gauze pad to the injection site for a few seconds. If needed, apply a small bandage to the area.

Inject your dose (prefilled syringe)

The directions below are for Ajovy prefilled syringes. You’ll need to repeat this process three times if you use Ajovy every 3 months.

• Carefully remove the protective cap by pulling it straight off. This exposes the needle. Throw the cap away in your regular household trash.

• Hold the syringe in one hand with your index (pointer) finger on one side of the barrel and your middle finger on the other. Make sure your thumb is free, because you’ll use it to inject your dose.

• With your other hand, gently pinch about 1 inch of skin at the injection site.

• Insert the needle into the pinched skin at a 45- to 90-degree angle. Let go of the pinched skin once the needle is fully inserted.

• Use your thumb to press down on the plunger. This will administer the medication.

• Keep pushing the plunger into the barrel until it can’t go any further.

• Once you’ve finished injecting, pull the needle out of your skin.

• Gently press (not rub) a cotton ball or gauze pad to the injection site for a few seconds. If needed, apply a small bandage to the area.

3. How to dispose of Ajovy

After you’ve injected Ajovy, immediately dispose of it in a proper container. Don’t re-cap the autoinjector or syringe since this can cause needlestick injuries. If you’re administering three injections, dispose of each injection device as soon as you remove it from your skin.

Don’t throw away used Ajovy autoinjectors or syringes in your regular household trash. An FDA-cleared sharps container is ideal for discarding needles and syringes. But a heavy-duty plastic container with a tight-fitting lid, such as an empty laundry detergent bottle, can be an acceptable alternative. The FDA provides additional information on how to dispose of syringes.

4. How to reduce pain when injecting Ajovy

Injection site reactions are the most common Ajovy side effects. Symptoms include pain, swelling, and redness where you injected your dose.

Injection site reactions typically go away on their own within a few days of using Ajovy. But you can help minimize them by doing the following:

• Place Ajovy at room temperature for about 30 minutes before injecting it.

• Avoid injecting Ajovy into areas of skin that are cut, bruised, or damaged.

• Use different injection sites for each of the 3 injections (if you use Ajovy once every 3 months).

• Insert Ajovy at the recommended angle for your injection device.

• Don’t rub the area with a cotton ball or gauze pad after injecting Ajovy.

5. Store Ajovy in the fridge

Store Ajovy in the refrigerator (between 36°F and 46°F) in its original carton. Only take it out of the fridge when you’re getting ready to inject your dose. Don’t freeze Ajovy.

If you forgot to put your Ajovy in the fridge, you can store it in its original carton at room temperature (up to 86°F) for up to 7 days. Make sure it’s away from heat sources and direct sunlight. Don’t return Ajovy to the refrigerator after it reaches room temperature. If you don’t use it within this 7-day window, discard it in a proper disposal container.

How to save on Ajovy

There are ways to save on Ajovy, which is available as a reference (“brand-name”) medication. If you have commercial insurance, you may be eligible to pay as little as $15 per prescription for Ajovy using a copay savings card from the manufacturer. If you’re uninsured or underinsured, you may be eligible for Ajovy’s patient assistance program, which offers the medication free of cost.

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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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