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.
Prevention of migraines in adults
Treatment of episodic (occasional) cluster headaches in adults
Emgality (galcanezumab) is a type of monoclonal antibody. It works as a calcitonin gene-related peptide (CGRP) antagonist. It blocks CGRP, a protein in the brain that plays a role in causing pain from migraine attacks and cluster headaches.
By blocking CGRP, Emgality (galcanezumab) can help prevent migraines. It can also help 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
Generally well tolerated
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
Someone from your care team will teach you how to inject Emgality (galcanezumab). They'll make sure you can do it on your own before you can inject at home. Don't try to inject the medication on your own without instructions.
Double check that you have the right version of Emgality (galcanezumab) and the number of injections you need for each dose. It depends on what you're using the medication for.
For preventing migraines: You can use either the 120 mg/mL Emgality prefilled pens and syringes. For the first dose, you'll need two injections of 120 mg, given one right after the other. For the rest of your doses, you only need one injection of 120 mg.
For treating cluster headaches: Use the 100 mg/mL Emgality prefilled syringes. For each dose, you'll need three injections of 100 mg, one right after the other.
Inject Emgality (galcanezumab) once a month. Choose a day of the month that you can remember and set up reminders on your calendar.
If you missed your usual monthly dose of Emgality (galcanezumab), inject the missed dose as soon as possible. Make sure you pay attention to the date you injected the missed dose. Your next injection will be one month from that date.
How to store Emgality (galcanezumab):
Store Emgality (galcanezumab) in the refrigerator in its original box to protect the medication from light. Don't let the medication freeze.
You can also keep Emgality (galcanezumab) in the original box at room temperature (up to 86°F) for up to 7 days. Once the medication reaches room temperature, don't put it back into the refrigerator.
How to prepare for your Emgality (galcanezumab) injection:
When you're ready for your dose, take Emgality (galcanezumab) out of the refrigerator. Let it sit out for 30 minutes so it can warm up to room temperature. Don't warm it up with hot water or with a microwave. This might damage the medication.
Before you inject, don't shake Emgality (galcanezumab). This can make the medication not work as well.
Be sure the liquid in your Emgality (galcanezumab) syringe or pen is colorless, or slightly yellow or slightly brown. Don't use it if the color is different, if the liquid looks cloudy, or if you see specks floating in it. If you notice these changes, throw away the syringe or pen because it might not be safe to use. Use a new syringe or pen.
How to inject Emgality (galcanezumab):
For the Emgality prefilled pens: Read the Instructions For Use for detailed step-by-step directions on how to inject. You can also watch the instructional video for guidance. Ask your care team if you're not sure how to inject the medication.
For the Emgality prefilled syringes: Review the detailed step-by-step Instructions For Use. Ask your care team if you have questions about using the syringes to inject Emgality (galcanezumab).
Inject Emgality (galcanezumab) under the skin of your stomach (at least 2 inches from your belly button). You can also inject under the skin of your thighs (at least 2 inches above the knee and 2 inches below the groin). And, someone else can help give the injection into the back of your upper arm or buttock. Don't inject into areas that are tender, bruised, red, or hard.
Choose a different spot to inject Emgality (galcanezumab) each time. This includes when you need to give yourself more than one injection, one after the other, for your dose. This helps keep your skin from getting irritated.
After each injection, throw away used syringes and pens in a sharps container. This helps lower the risk of poking yourself by accident. Buy a sharps container at your local pharmacy. You can also use a puncture-resistant container, like an empty laundry detergent bottle, as an alternative.
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. Symptoms can include hives (patches of red, raised skin that might feel hot or itchy) or rash. It can also look like swelling of the face and around the eyes, swollen throat, trouble breathing, wheezing, and trouble swallowing.
Watch for any allergic reactions after injecting Emgality (galcanezumab), even after a few days. Get medical help right away if this happens.
Some people developed high blood pressure after using Emgality (galcanezumab). This can happen any time during treatment. But most people noticed it within a week of starting the medication.
Ask your healthcare professional how often you should check your blood pressure at home. Tell your primary care provider if it stays higher than usual. They might recommend starting blood pressure medication to help.
Risk factors: History of Raynaud's phenomenon
Some people who've taken Emgality (galcanezumab) have had Raynaud's phenomenon, which is a problem with blood flow to the fingers and toes. If you already have Raynaud's, this medication could make it worse.
This blood flow problem can lead to color changes, pain, and numbness in your fingers and toes. Some people might need a trip to the hospital for serious pain.
Get medical help right away if you notice any signs of Raynaud's phenomenon while taking Emgality (galcanezumab). Look out for signs like numb fingers or toes, skin color changing from pale to blue to red, or pain in these areas. Your care team can work with you to help you manage this problem.
Migraine prevention: The typical dose is 240 mg (two injections of 120 mg each, one right after the other) once. Then a month later, the usual dose changes to 120 mg once a month. Inject the medication under the skin.
Treatment of episodic cluster headaches: Start the medication at the beginning of your cluster headache cycle. The typical dose is 300 mg (three injections of 100 mg each, one right after the other) once a month. Inject the medication under the skin. Stop taking the medication when your cluster cycle ends.
Prevention of migraines in adults
Treatment of episodic (occasional) cluster headaches in adults
Prevention of migraines in adults
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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.
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Eli Lilly and Company. (2019). Instructions for use: Emgality® (em-GAL-it-ē) (galcanezumab-gnlm) injection, for subcutaneous use prefilled pen.
Eli Lilly and Company. (2019). Instructions for use: Emgality® (em-GAL-it-ē) (galcanezumab-gnlm) injection, for subcutaneous use prefilled syringe.
Eli Lilly and Company. (2025). Emgality- galcanezumab-gnlm injection, solution [package insert]. DailyMed.
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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.
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U.S. Food and Drug Administration. (2025). Where and how to dispose of unused medicines.
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