5 Emgality Side Effects and How to Manage Them

If you or a loved one are living with painful migraines, you’re well aware of how headaches, sensitivity to light and sound, and nausea can disrupt your daily routine. Understandably, addressing these symptoms is a priority — especially if they happen often.

Emgality (galcanezumab) is one management option you may have heard of. This injectable medication is a monoclonal antibody that works by blocking calcitonin gene-related peptide (CGRP) — a protein that causes blood vessels in your brain to swell and inflict pain. By blocking CGRP, Emgality can help prevent migraine symptoms over time. It can also treat cluster headaches, a type of headache that stirs up severe pain on one side of the head.

For most people, Emgality is well tolerated. But if you’re prescribed Emgality, there are still some side effects you should be aware of.

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Emgality side effects at a glance

Emgality can cause a few different side effects to watch out for. 

Relatively common and mild Emgality side effects include:

• Injection site reactions

• Sinus and throat infections 

• Runny nose 

• Back pain

• Joint pain

Less common, but potentially serious, risks include:

• Antibody development

• Anaphylaxis 

• Hypersensitivity reactions

Here, we’ll discuss five notable Emgality side effects and how you can manage them.

1. Injection site reactions

Emgality is injected under the skin once a month. You can inject the medication into your stomach or the front of your thighs. If you don’t want to inject the medication yourself, another person can inject the medication in the back of your upper arm or buttocks.

Regardless of where it’s injected, injection site reactions are common — especially after your first dose. These reactions may appear as redness, pain, and itching in the area where the injection was given. In initial studies, 18% of people who received Emgality had these reactions compared to 13% who used a placebo (injection with no medication).

Thankfully, most of these reactions are mild. They also tend to improve the day after receiving the injection.

Managing injection site reactions

To lessen the chance of injection site reactions, it’s best to wash your hands and clean your injection site with an alcohol wipe before you inject the medication. This helps lower the risk of infection.

Try to change the location of your injection site with each dose, as well. You can do this by switching arms or areas on your stomach, thighs, or buttocks with each dose. It’s also best to avoid injecting the medication into the belly button area, scar tissue, or areas where the skin is red or feels sore. You should also wait 30 minutes for the medication to come to room temperature to help minimize injection discomfort. Cold injections can hurt more.

Reach out to your healthcare professional (HCP) if your injection site reactions still bother you after a few days. This could be a sign that you aren’t injecting Emgality correctly. You can also ask your HCP if it’s safe for you to take over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil).

2. Antibody development

Over time, your body may develop antibodies to Emgality. These are called “anti-drug antibodies.” These antibodies can bind to Emgality and interfere with it, meaning it might not work as well.

In three Emgality clinical trials, anti-drug antibodies were seen in up to about 9% of people receiving this medication. This antibody was also detected in nearly 2% of people who only received placebo injections.

Tell your HCP if your migraines are coming back and the medication doesn’t seem to be working like it used to. They may switch you to another medication if they suspect you’ve developed antibodies to Emgality.

3. Common cold symptoms

Emgality may cause common cold symptoms. In one clinical trial, up to 18% of people experienced cold symptoms while receiving Emgality.

If you develop mild cold symptoms, try to get plenty of rest and stay hydrated. Depending on your symptoms, there are also home remedies and OTC products that can offer short-term relief. The best treatment option will depend on your symptoms.

For instance, if you have a sore throat, try gargling warm salt water or asking your HCP if it’s safe to take OTC pain relievers, such as ibuprofen. Nasal decongestants, like pseudoephedrine (Sudafed), might be an option for temporary relief if you have a stuffy nose. But keep in mind that decongestants should be avoided in people with high blood pressure or diabetes.

Most common cold symptoms should clear up on their own after a few days. If they don’t, talk to your HCP. If they suspect your symptoms are caused by a bacterial infection rather than a virus, taking an antibiotic may be necessary.

4. Back or joint pain

Some people receiving Emgality have occasionally reported back or joint pain. Experts don’t fully know why this happens. Thankfully, this side effect tends to be mild to moderate in severity.

Depending on your symptoms, you can try gentle stretching or applying ice or heat to help ease discomfort. When needed, OTC medications, such as ibuprofen or naproxen (Aleve, Naprosyn), can temporarily help relieve joint and muscle pain.

Let your HCP know if your back or joint pain becomes persistent, bothersome, or gets worse at any point. They can determine if it’s caused by Emgality or something else and come up with a personalized plan to manage it.

5. Allergic reactions

As with all medications, Emgality may cause allergic reactions in some people. Mild symptoms of an allergic reaction can include itching, hives, and skin rashes. More serious symptoms can include trouble breathing and swelling of the face, lips, or tongue (anaphylaxis).

Stop administering Emgality and seek emergency medical care right away if you have breathing difficulties or swelling of the lips, mouth, or tongue. If your symptoms feel mild, it’s still a good idea to check in with your HCP and ask about next steps.

Keep in mind: Injection site reactions and mild allergic reactions can look similar. Both may include symptoms such as itching and redness. Talk to your HCP if you aren’t sure what’s causing your symptoms.

Does Emgality have less side effects than other migraine medications?

Yes. Emgality has fewer side effects than triptans, a popular group of migraine medications. This is because triptans narrow blood vessels in certain parts of your body. This raises the risk for heart attacks, stroke, and high blood pressure. Because of this, people with heart problems should generally avoid taking triptans. By comparison, most people with heart problems, high blood pressure, or a history of stroke can use Emgality.

What’s more, triptans may cause rebound headaches. These types of headaches happen when you take too much medication. Emgality hasn’t been connected to this.

Triptans aside, specific CGRP medication side effects can slightly vary by drug and formulation. For example, Aimovig (erenumab) is an injectable medication that’s similar to Emgality, but it’s been linked to high blood pressure within the first week of treatment. And if you’re receiving an oral CGRP medication (“gepant”), such as Nurtec ODT (rimegepant), stomach-related side effects like nausea and upset stomach are possible.

Does Emgality cause weight gain?

Emgality probably won’t cause weight gain (or weight loss). But the likelihood of this risk isn’t fully clear.

Weight changes aren’t reported in the medication’s official labeling. But some people very rarely experienced weight gain in one of Emgality’s initial clinical trials. And outside of clinical trials, weight gain has only been reported anecdotally among some people who use the medication.

Talk to your HCP for more information on the possible risk of weight gain. If weight gain is something you’re concerned about, they can offer tips and tricks for keeping this possibility in check. Thankfully, if weight gain hypothetically does occur, it shouldn’t affect how well Emgality works.

Does Emgality have any long-term side effects?

Emgality is considered a long-term maintenance medication. It’s designed to prevent migraines over time. So it’s normal to wonder if Emgality will cause side effects that will linger or won’t go away.

It’s not too likely. 

In one 12-month study, 95% of people continued treatment without experiencing any serious side effects. Some side effects were reported throughout the study time frame, but they weren’t directly attributed to longer-term use. This includes reports of injection site reactions, constipation, elevated blood pressure, and the development of anti-drug antibodies. What’s more, measurements such as blood work, vital signs, and heart monitoring didn’t show any meaningful differences compared to people who didn’t receive Emgality.

At this time, there haven’t been any studies that analyze the medication’s risks and side effects beyond 1 year of treatment.

When should you contact your healthcare professional about Emgality side effects?

Emgality side effects — especially injection site reactions — should gradually improve as your body gets used to the medication. But make sure to tell your HCP if you have any side effects that continue to bother you or get worse at any point. They can help manage your symptoms or change your treatment plan altogether.

Certain side effects are also more serious than others. Contact your HCP immediately if you think you’re having an allergic reaction to Emgality. Call 911 if you’re having trouble breathing or experiencing swelling in your lips, mouth, or tongue. These symptoms are considered a medical emergency and warrant immediate care.

Why trust our experts?

Written by:

Claire Athanas, PharmD Candidate

Claire Athanas, PharmD candidate, is a pharmacy intern with Walgreens in Chicago. She previously worked at CVS Pharmacy and CVS SimpleDose specialty pharmacy.

Written by:

Nikki Javit, PharmD

Nikki Javit, PharmD, is a clinical pharmacist with certifications in international travel medicine, immunization delivery, and pharmacogenomics. She received her bachelor’s of science in biology from Indiana University Bloomington and her doctor of pharmacy degree from Butler University.

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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