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.
Migraine prevention
Episodic (occasional) cluster headaches
Emgality (galcanezumab) is a monoclonal antibody. It blocks a protein in your body called calcitonin gene-related peptide (CGRP) ligand. Your nerves release CGRPs during migraine attacks and cluster headaches. CGRPs cause the blood vessels in your brain to swell, which can lead to pain. When Emgality (galcanezumab) blocks these proteins, it can prevent migraines and ease pain from cluster headaches.
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):
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
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
Double check that you received the correct form and dose of Emgality (galcanezumab) before you start treatment. The 120 mg/mL prefilled pens and syringes are used to prevent migraines. The 100 mg/mL prefilled syringes are used to treat cluster headaches.
Someone from your care team should train you on how to properly inject this medication at home. Don't try to inject it on your own without instructions.
Tips on how to store Emgality (galcanezumab):
Store Emgality (galcanezumab) in the refrigerator (not in the freezer) in its original container. The original container protects the medication from light. If the medication is exposed to light, it might not work as well.
Emgality (galcanezumab) can be stored at room temperature (up to 86°F), away from light, for up to 7 days. Once the medication is stored at room temperature, don't put it back into the refrigerator.
Tips for preparing for Emgality (galcanezumab) injections:
Before you inject Emgality (galcanezumab), leave it at room temperature (up to 86°F) for 30 minutes. Don't warm it up with hot water or with a microwave. This might warm up the medication too much and affect how well it works.
Don't shake Emgality (galcanezumab). Shaking it can cause the medication to not work as well.
Look at the liquid in your Emgality (galcanezumab) syringe or pen before you use it. It should be colorless, or slightly yellow or slightly brown. Don't use the medication if the color is different. Also don't use it if the liquid looks cloudy or you can see specks floating in it. If you notice these changes, throw away your medication properly.
Tips on how to inject Emgality (galcanezumab):
Prefilled pens: It's important to read the Instructions For Use or watch the instructional videos before using Emgality (galcanezumab) pens to make sure you use it correctly.
Prefilled syringes: It's important to read the Instructions For Use or watch the instructional videos before using Emgality (galcanezumab) syringes to make sure you use it correctly.
Inject Emgality (galcanezumab) under the skin of your stomach, thighs, back of the upper arm, or the buttocks. Don't inject in areas that are tender, bruised, red, or hard. If you're giving yourself multiple Emgality (galcanezumab) injections, one right after the other, make sure to choose a different injection site for each injection.
Be sure to throw away used syringes and pens in a sharps container. This will lower the risk of needlestick injuries. If you don't have a sharps container, you can purchase one at your local pharmacy. You can also use a puncture-resistant container as an alternative sharps container, such as an empty laundry detergent bottle.
Emgality (galcanezumab) 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.
Emgality (galcanezumab) can cause serious allergic reactions, such as anaphylaxis. This can sometimes happen days after using it. Symptoms can include hives (patches of red, raised skin that might feel hot or itchy), rash, swelling of the face and eyes, swollen throat, trouble breathing, wheezing, cough, trouble swallowing, vomiting, diarrhea, and passing out. If you experience these symptoms, stop Emgality (galcanezumab) and get medical help right away.
As with similar medications, it's possible for your body to form antibodies against Emgality (galcanezumab). Based on clinical studies, about 12% of people developed these antibodies after a year of Emgality (galcanezumab) treatment. More research is needed to understand how these antibodies affect the safety of Emgality (galcanezumab) or how well this medication works. Talk with your provider if you're concerned about Emgality (galcanezumab) and antibody formation.
Migraine prevention: The typical dose is 240 mg (two injections of 120 mg each, one right after the other) injected under the skin once when you first start the medication. Then, inject 120 mg under the skin once a month.
Episodic cluster headaches: The typical dose is 300 mg (three injections of 100 mg each, one right after the other) injected under the skin once at the start of your cluster period. Then, inject 300 mg under the skin once a month, until the end of your cluster period.
Migraine prevention
Episodic (occasional) cluster headaches
Prevention of migraines in adults
Chronic chest pain
Atrial fibrillation (A.Fib)
Heart protection after a heart attack
Tremors
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Camporeale, A., et al. (2018). A phase 3, long-term, open-label safety study of Galcanezumab in patients with migraine. BioMed Central Neurology.
Durham, P. L. (2006). Calcitonin gene-related peptide (CGRP) and migraine. Headache.
Eli Lilly and Company. (2019). EMGALITY® (em-GAL-it-ē) (galcanezumab-gnlm) injection, for subcutaneous use Prefilled Pen [package insert].
Eli Lilly and Company. (2019). EMGALITY® (em-GAL-it-ē) (galcanezumab-gnlm) injection, for subcutaneous use Prefilled Syringe [package insert].
Eli Lilly and Company. (2021). Emgality- galcanezumab-gnlm injection, solution [package insert]. DailyMed.
Ha, H., et al. (2019). Migraine headache prophylaxis. American Family Physician.
Terhart, M., et al. (2021). Deterioration of headache impact and health-related quality of life in migraine patients after cessation of preventive treatment with CGRP(-receptor) antibodies. The Journal of Headache and Pain.
U.S. Food and Drug Administration. (2021). Sharps disposal containers.
U.S. Food and Drug Administration. (2024). Where and how to dispose of unused medicines.
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