Ajovy (fremanezumab or fremanezumab-vfrm) is an injection under the skin that helps prevent migraines in adults. This medication is convenient because it only needs to be used once every month or once every 3 months. The only observed side effects in clinical studies were injection-site reactions (e.g., pain, swelling, redness). Ajovy (fremanezumab) is available as a prefilled autoinjector pen and a prefilled syringe. It's currently only available as a brand-name medication; there's no generic yet.
Prevention of migraines in adults
Ajovy (fremanezumab) is a calcitonin gene-related peptide (CGRP) receptor blocker. It's a monoclonal antibody that blocks a protein called calcitonin gene-related peptide (CGRP) in the brain and nervous system. CGRP is thought to be involved with migraines and causing pain. By blocking CGRP, Ajovy (fremanezumab) helps block migraines from happening.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Taken only once per month or once every 3 months
Can store at room temperature for up to 7 days, if needed
Available as a prefilled syringe and a prefilled autoinjector
Manufacturer offers a savings program for certain people
Might be difficult for some people to use properly
Only used for preventing migraines (not for treating a migraine attack)
Available as a brand-name medication only
Hasn't been studied in children younger than 18 years old
You should receive training from your provider or pharmacist on how to use Ajovy (fremanezumab). Make sure you know how to give yourself the medication to avoid accidentally hurting yourself or wasting the medication. Read the instructions for use for the autoinjector or the prefilled syringe. Contact your pharmacist or provider if you have any questions.
Ajovy (fremanezumab) comes as a prefilled syringe or a prefilled autoinjector that contains 225 mg of medication. It's given either once per month or once every 3 months. If your prescribed dose is 675 mg every 3 months, then you'll have to give yourself three 225 mg injections in a row to get your full dose. Make sure you choose a different area of skin for each injection to help prevent bruising or irritation on your skin.
Keep Ajovy (fremanezumab) in the carton it comes in to protect it from light. Store it in the refrigerator; don't freeze it. When you're ready for your dose, take the medication out of the refrigerator and lay it on a flat surface to warm up for at least 30 minutes. Don't try to shake or warm up the medication any other way.
Inject Ajovy (fremanezumab) under the skin into the fatty tissue of the front of your thighs (at least 2 inches above your knee and 2 inches below your groin) or stomach area (at least 2 inches away from the belly button). You can also inject the medication into the fleshy area at the back of your upper arms with someone else's help. Never inject the medication into your muscle or vein.
Always check the medication solution to make sure it's either clear and colorless or slightly yellow before using it. If it's cloudy, discolored, has particles (chunks), or frozen, don't use it. Additionally, don't use Ajovy (fremanezumab) if any part of the syringe or autoinjector is broken or has any visible damage to it (e.g., cracks, leaks). Use a new syringe or autoinjector.
Each Ajovy (fremanezumab) syringe and autoinjector provides a single dose of medication. Throw away the syringe and autoinjector after each use by placing them in a sharps container or something made of heavy-duty plastic (e.g., empty milk carton, laundry detergent bottle). This lowers the risk of needlestick injuries. Don't throw them away in your trash can. Learn more about how to throw away your sharps on the FDA's website.
If you forget to take your dose at the time you normally take it, inject the medication as soon as you remember. Then, continue to take Ajovy (fremanezumab) each month (or every 3 months) from the date of your last dose.
If you're traveling and don't have access to a refrigerator, you can keep Ajovy (fremanezumab) at room temperature for up to 7 days. Don't put Ajovy (fremanezumab) back in the fridge after it has reached room temperature.
Ajovy (fremanezumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reactions to Ajovy (fremanezumab) are possible. These reactions can include hives, rash, and itching. They're typically mild, but can sometimes be severe. Some people also experienced facial swelling and anaphylaxis (closing of the throat), which can sometimes be life-threatening. In general, allergic reactions can happen within hours to one month after you take Ajovy (fremanezumab). If you notice dizziness, a choking sensation, difficulty breathing, hives, swelling around your eyes, or swelling of the lips or tongue after using Ajovy (fremanezumab), get medical attention right away.
There are two different dosing options to choose from.
Option 1: Inject 225 mg under the skin once every month.
Option 2: Inject 675 mg under the skin once every 3 months.
Prevention of migraines in adults
Prevention and treatment of migraines with or without aura in adults
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Dodick, D. W., et al. (2018). Effect of fremanezumab compared with placebo for prevention of episodic migraine: A randomized clinical trial. Journal of the American Medical Association.
Silberstein, S. D., et al. (2017). Fremanezumab for the preventive treatment of chronic migraine. The New England Journal of Medicine.
Teva Migraine Pregnancy Registry. (2021). About the Teva Migraine Pregnancy Registry.
Teva Pharmaceuticals USA, Inc. (2024). Ajovy autoinjector.
Teva Pharmaceuticals USA, Inc. (2024). Ajovy prefilled syringe.
Teva Pharmaceuticals USA. Inc. (2022). Ajovy- femanezumab-vfrm injection [package insert]. DailyMed.
U.S. Food and Drug Administration. (2021). Safely using sharps (needles and syringes) at home, at work and on travel.
Wattiez, A., et al. (2020). Calcitonin gene-related peptide (CGRP): Role in migraine pathophysiology and therapeutic targeting. Expert Opinion on Therapeutic Targets.
Winner, P. K., et al. (2019). Early onset of efficacy with fremanezumab for the preventive treatment of chronic migraine. Headache.
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