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Compare Emgality vs. Topamax

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Emgality (galcanezumab) and topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) are both used to prevent migraines, but they work in different ways and have different uses. Emgality is a monoclonal antibody that blocks a protein called calcitonin-gene related peptide (CGRP) to prevent migraines and treat cluster headaches. It is given as a monthly injection under the skin. On the other hand, topiramate is an antiepileptic medication that can prevent migraines and treat various types of seizures. It is taken orally, either once or twice daily, and is available in both immediate-release and extended-release forms, as well as a liquid. Emgality is only available as a brand-name medication, while topiramate is available in generic forms, making it potentially more affordable. Emgality's common side effects include injection site reactions, while Topiramate can cause side effects like drowsiness, weight loss, and trouble thinking clearly. Additionally, topiramate has more serious risks, such as vision problems and high blood acid levels, and it can interact with many other medications.

Emgality (galcanezumab)
Topiramate
Emgality (galcanezumab)
Topiramate
Summary of Emgality vs. Topamax
Summary for Monoclonal antibody
Prescription only
Emgality (galcanezumab or galcanezumab-gnlm) is a monoclonal antibody that's used to prevent migraine attacks and to treat cluster headaches in adults. Emgality (galcanezumab) works by blocking a specific protein in the brain that can cause migraines and headaches. This medication is injected under the skin monthly. Some common side effects of Emgality (galcanezumab) include pain, itching, and rash at the injection site.
Summary for Antiepileptic
Prescription only
Topiramate is a prescription medication that can be used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines. It comes in immediate-release and extended-release tablets and capsules, as well as a liquid. Topiramate is typically taken by mouth once or twice daily, depending on what formulation you're using. Some forms of topiramate are available as lower-cost generic medications.
Indications of Emgality vs. Topamax
Indications for

•Migraine prevention

•Episodic (occasional) cluster headaches

Indications for

•Seizures (partial seizures, tonic-clonic seizures, Lennox-Gastaut syndrome)

•Migraine prevention
Pros and Cons of Emgality vs. Topamax
Pros and Const for Monoclonal antibody
Pros

•Only needs to be given once a month

•Good option for people who have a hard time taking medications by mouth

•Patient assistance programs are available to help lower the cost

Cons

•Not a good option for people who don't like needles

•Needs to be stored in a refrigerator

•Not known whether Emgality (galcanezumab) works well or is safe in young children, or people who are pregnant or breastfeeding

Pros and Const for Antiepileptic
Pros

•Can be used on its own or with other medications to control seizures

•Available in short-acting and long-acting forms, so options to take once or twice daily

•Available as a solution (Eprontia), so it's convenient for people who have trouble swallowing

•Can be used to treat different types of seizures

•Can be used to treat seizures in both adults and children

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Can cause kidney stones

•Can cause serious eye problems

•Interacts with many medications, such as warfarin (Coumadin), phenytoin (Dilantin), and divalproex (Depakote)

•Children taking this medication for long periods of time will need to have their doses adjusted often due to changes in body weight as they grow
Common Side Effects of Emgality vs. Topamax
Common Side Effects for

•Pain, itching, warmth, and other injection site reactions (up to 20%)

•Sore throat, runny nose (up to 18%)

•Back pain (up to 10%)

Please note: Side effects were reported by people who took Emgality (galcanezumab) in a clinical study.
Common Side Effects for
Please note: These are common side effects reported by children and adults who took immediate-release topiramate. Frequency of side effects can differ based on your age, as well as the dose and formulation of topiramate you're taking.

•Feeling "pins and needles"

•Drowsiness

•Weight loss

•Nervousness

•Fatigue

•Dizziness

•Lack of appetite

•Trouble sleeping

•Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)

•Fever

•Change in taste

•Trouble moving or keeping balance
Warnings of Emgality vs. Topamax
Common Side Effects for

•Serious allergic reactions

•Antibody formation against Emgality (galcanezumab)

Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Higher level of acid in blood

•Suicidal thoughts or behavior

•Problems with mood and thinking clearly

•Higher ammonia level in blood

•Serious birth defects

•Skin reactions

•Withdrawal seizures

•Interaction with other medications
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Compare Emgality vs. Topamax

Key takeaways

Summary of Emgality vs. Topamax

Indications of Emgality vs. Topamax

Pros and Cons of Emgality vs. Topamax

Common Side Effects of Emgality vs. Topamax

Warnings of Emgality vs. Topamax

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