Aimovig vs. Ajovy for Chronic Migraine Prevention: 5 Differences You Should Know About

Are you tired of enduring the relentless grip of chronic migraines? The excruciating pain and disruption of your daily life can make it feel as though you’re in an endless battle. And when acute treatments aren’t cutting it, you may want something that will stop migraines from happening in the first place.

The good news is that there’s a newer class of medications that can help reduce monthly migraine days in adults. Of these, Aimovig (erenumab-aooe) and Ajovy (fremanezumab-vfrm) are two injectable options your healthcare provider may suggest if other preventative treatments haven’t worked for you.

Aimovig and Ajovy have some similarities. But there are also several differences you may want to consider, including how often you need to inject a dose. We cover the five main differences between Aimovig and Ajovy below.

1. Aimovig and Ajovy work in similar, but slightly different ways

Both Aimovig and Ajovy work against a molecule called calcitonin gene-related peptide (CGRP). CGRP is involved in the release of chemicals that trigger migraine headaches. And researchers have found that CGRP levels tend to be higher in people with chronic migraines. 

Aimovig and Ajovy block the effects of CGRP in slightly different ways. They’re both monoclonal antibodies — lab-made proteins made to bind to certain targets in the body. But Aimovig binds to CGRP receptors (binding sites), which prevents CGRP from attaching and triggering its effects. Ajovy, on the other hand, binds to the CGRP molecule itself.

So, does this make a difference? Possibly. A recent meta-analysis suggests that medications targeting the CGRP molecule, like Ajovy, may work better than those targeting the CGRP receptor, like Aimovig. But more research is needed to know for sure.

Keep in mind: Not everyone responds to this type of migraine prevention medication. And others may take longer to respond — sometimes greater than 12 weeks (3 months). You may also need to try a few different medications before finding one that works for you.

2. Ajovy can be injected less often compared to Aimovig

Aimovig is a once-monthly injection that’s given under the skin (subcutaneously) on your stomach, thigh, or upper arm. 

Ajovy can also be injected once a month under the skin of the same areas. But you also have the option to inject Ajovy less often — every 3 months. However, Ajovy is only available in one dose. This means that if you choose the 3-month option, you’ll need to inject three doses consecutively each time.

If convenience is an important feature for you, Ajovy can be a good option. Keep in mind that it won’t cut down on the total number of injections you receive, but you’ll be able to inject it less often.

3. Aimovig and Ajovy can cause different side effects

Aimovig and Ajovy can both cause injection-site reactions such as pain and redness where you inject your dose. Hypersensitivity reactions, including rash, itching, and severe allergic reactions, are possible. Hair loss has also been reported.

But Aimovig has been linked to a few other side effects that weren’t reported during Ajovy’s initial clinical trials. These include:

• Constipation

• Muscle cramps or spasms

• New or worsening high blood pressure

Based on your health history, your healthcare provider can determine which option is best for you. For example, they may choose Ajovy if you already have high blood pressure. The choice of medication can also depend on your insurance coverage, which we’ll discuss later on.

4. Aimovig and Ajovy injection pens work differently

Both Aimovig and Ajovy are available as single-dose autoinjector pens and syringes. Both pens have a protective cap that should be removed immediately before injecting your dose. But each autoinjector pen works differently to deliver the medication.

To use an Aimovig pen, firmly press the pen against your skin. To deploy the needle, you need to push down the purple “start button” at the top of the pen. You won’t receive your dose unless you do this step.

The Ajovy pen doesn’t have a button you need to push. Instead, the pressure from pushing the blue end of the pen down against your skin triggers the injection. Because of this, some people may find that the Ajovy pen is easier to use, especially if you have hand dexterity issues.

Despite this difference, each pen is stored the same way. Prior to use, the pen is kept in the refrigerator. But it should be taken out at least 30 minutes before a dose so it can reach room temperature, which helps to lessen injection pain. If a pen is removed from the refrigerator, it must be used within 7 days.

5. Aimovig and Ajovy may be covered differently under your insurance plan

If you have prescription coverage, your insurance plan likely has a formulary — a list of covered brand-name and generic medications. Some medications may be preferred over others. In this case, your plan may prefer either Aimovig or Ajovy over the other.

It’s best to check with your specific plan to see which medication is covered and your expected cost. If your copay is still too high, Aimovig and Ajovy manufacturer copay savings cards can help make your prescription more affordable. And if you’re eligible, patient assistance programs are also available.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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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