Ajovy vs. Emgality for Migraine: Important Differences and Potential Risks.

Key takeaways

Ajovy (fremanezumab) and Emgality (galcanezumab) are both medications used to prevent migraines, but they have some differences. Ajovy is a CGRP receptor blocker, while Emgality is a monoclonal antibody that blocks the CGRP ligand. Ajovy is available only as a brand-name medication and can be injected once a month or once every three months. Emgality, also a brand-name medication, is injected once monthly. Ajovy is used solely for migraine prevention, while Emgality can also treat episodic cluster headaches. Common side effects for Ajovy include injection-site reactions like pain and swelling, while Emgality can cause injection-site reactions, sore throat, and back pain. Both medications need to be stored in the refrigerator but can be kept at room temperature for up to 7 days.

Ajovy

(fremanezumab)

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Emgality

(galcanezumab)

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Summary for Ajovy

Prescription only

Ajovy (fremanezumab or fremanezumab-vfrm) is a type of migraine medication called a calcitonin gene-related peptide (CGRP) antagonist. It's an injection given under the skin to help prevent migraines in adults. It can also help prevent episodic migraines in children ages 6 years and older who weigh at least 99 lbs. This medication is injected once a month or once every 3 months. It's injected using either the prefilled autoinjectors or syringes. Side effects include injection-site reactions like pain, swelling, and redness.

Indications for Ajovy

Prevention of chronic migraines in adults
Prevention of episodic migraines in children 6 to 17 years old who weigh at least 99 lbs

Pros and Cons for Ajovy

Pros

Can help reduce the number of migraine days per month in adults and in children after a few months of treatment
Taken once a month (or even once every 3 months for adults)
Available as a prefilled syringe and a prefilled autoinjector

Cons

Must inject it under the skin
Not used for relieving and treating an active migraine
Might be hard for some people to use properly

Common Side Effects for Ajovy

Pain, swelling, redness, or other reaction at the injection site (43-45%)

Warnings for Ajovy

Allergic reactions
High blood pressure
Raynaud's phenomenon

Summary for Emgality

Prescription only

Emgality (galcanezumab or galcanezumab-gnlm) is an injectable medication that can help prevent migraine attacks in adults. It can also help treat cluster headaches in adults. This medication is a monoclonal antibody that works as a CGRP antagonist. It blocks the CGRP protein in the brain that can cause migraine and headache pain. Emgality (galcanezumab) comes as a prefilled pen and syringe. You inject one dose of the medication under the skin monthly. Some common side effects include pain, itching, and redness at the injection site.

Indications for Emgality

Prevention of migraines in adults
Treatment of episodic (occasional) cluster headaches in adults

Pros and Cons for Emgality

Pros

Only needs to be given once a month
Good option for people who have a hard time taking medications by mouth
Generally well tolerated

Cons

Not a good option for people who don't like needles
Need to store in a refrigerator
Not known if the medication works well or is safe in children, during pregnancy, or while breastfeeding