Comparing CGRP blockers is the next big challenge for Migraine patients. Now that we have three new preventive options specifically designed for Migraine, we’re faced with that all-important question: Which one should we choose: Aimovig, Ajovy, or Emgality?
Which one works better?
It’s too soon to know if one treatment is more effective for any given situation. We just don’t know if one works better than others for specific types of Migraine, or certain populations based on age, gender, or comorbidities. Getting those answers will require years of observing patient responses to treatment.
David Watson, MD, shares his perspective on these new treatment options:
It is still way too early to determine which of these new medications is “better”, or even if there is real difference. Like most treatment options, what works for one person perfectly might not be so great for someone else. The big news here is that we have three new treatment options, all of which appear to be effective for preventing migraine attacks. That’s great news.
Other ways to compare
Until then, absent a recommendation from our doctors, the choice may be a matter of personal preference. Although very similar, there are slight differences. These differences may help us choose which one is right for us.
- Cost – All three are equally priced. However, coverage and co-pay costs from individual insurance plans may affect our choice. Each company’s assistance programs may affect our decision, too.
- Accessibility – Do we prefer a mail order or local pharmacy? How long must we wait to receive our medication? Will pharmacies stock each medicine equally?
- Convenience – Ease of storage can affect our decision, too. Some of these medications must be shipped and require a signature. Do we have the time and flexibility to accommodate this requirment? All three must be refrigerated until shortly before use and none can be exposed to high temperatures.
- Delivery Method – Some prefer auto-injectors while others would rather use a syringe. That personal preference must be taken into consideration when making a treatment choice.
- Dosing Schedule – Is once a month convenient enough, or would we rather choose a quarterly option? Some of us may need two or three doses, depending on the dosing schedule. Are we prepared for two injections? What about three?
- Side Effects – All three have the potential for injection site skin irritation. One may also cause constipation. If constipation is already a problem for us, we may decide to skip that one in favor of the other two. Also, because they’re all new, there may be side effects that didn’t appear in clinical trials. How comfortable are we with that unknown risk?
- Allergies – One treatment uses rubber tips derived from latex which could be a problem if we have a latex allergy. The other two do not use latex.
Side-by-Side Comparison
Take a closer look at how they all stack up against each other. Pay close attention to the variables that matter most.
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| Retail Cost: | $575 per dose | $575 per dose | $575 per dose |
| Savings Programs: | $5 co-pay with commerical insurance, 12-months free with commercial insurance if not covered | $0 co-pay with commercial insurance | Free for 12 months with commercial insurance |
| Manufacturer: | Amgen | Teva Pharmaceuticals | Eli Lilly and Company |
| Date Approved: | May 17, 2018 | Sept. 14, 2018 | Sept. 27, 2018 |
| Indication: | Migraine prevention in adults | Migraine prevention in adults | Migraine prevention in adults |
| Action: | Targets the CGRP receptor | Targets CGRP | Targets CGRP |
| Half-life: | 28 days | 31 days | 27 days |
| Storage: | Refrigeration required. Do not freeze. Use within 7 days after removal from refrigerator. | Refrigeration required. Do not freeze. Use within 24 hours after removal from refrigerator. | Refrigeration required. Do not freeze. Use within 7 days after removal from refrigerator. |
| Dose: | 70 mg or 140 mg | 225 mg | 120 mg |
| Frequency: | Monthly (1-2 doses) | Monthly (1 dose) Quarterly (3 doses) |
Initial loading dose (2 doses) Monthly (1 dose) |
| Injection site: | Abdomen or thigh (self-injection) Upper arm (injection by others) |
Abdomen or thigh (self-injection) Upper arm (injection by others) |
Abdomen or thigh (self-injection) Upper arm or buttocks (injection by others) |
| Side Effects: | Injection site reaction, constipation | Injection site reaction | Injection site reaction |
| Allergies: | Needle shield and cap contain dry natural rubber (a derivative of latex) | Latex-free | Latex-free |
Keep watching for more!
Remember that no medication works the same for everyone. If one of these choices doesn’t work, it may be worth trying another. No matter what, don’t give up. There are more options still to come!
Has anyone had good success with Emgality, but had to switch to Ajovy? I have been using the discount card for Emgality, but I don’t know how long it will last and with my insurance it used to be a tier 3 drug, $50 a month, starting today it is a tier 4 drug which makes it about $165 a month. No reason for why it changed, but i doubt if i’m the only one. If I switch to Ajovy I can probably use that plan for a year, but is it as good? anyone have side effects after switching? I’m so stressed. I’m in tears and I don’t know what to do.
Emgality is the best I think this is my 2nd pen
I have been on Ajovy for about 18 months, taking monthly injections. It has been life changing. The affect was gradual, however. I also take a number of vitamins my neurologist told me to take, magnesium, vitamins b12, b2, D, co q10, etc. I still get occasional migraines, and Ubrelvy has been also wonderful to treat them when I do. I do have migraine food triggers of benzoates (artificial and naturally occurring like broccoli and spinach), nitrites, TBHQ, cinnamon, berries, pectin, soy lecithin, soy flour, soy protein, and fermented foods/drinks and a few more items. My list is fairly long – but as long as I take Ajovy, take my vitamins, and avoid my triggers I can go nearly a month with zero to just a couple migraines. My family life, work life, and personal time is so much better and I feel my career has been on the upswing as a result, too. I have not noticed any other side affects other than the first month I had an enlarged lymph node under my arm and so freaked out it could be cancer but apparently that is common with any arm shot we have now learned with all the vaccinations ;). Agree with the others – best advancement in history for those suffering from migraine disease.
I took Emgality for three months and noticed a huge decrease in my migraines- it was great! It took about a month to kick in. However, about 3 months in, I noticed my hair was becoming super thin right around my face in the front. Sadly, I stopped taking Emgality and back to being reactive with meds instead of proactive. I wish I didn’t have to choose between having hair and being migraine free. 🙁
Been off Emgality for five months and hair is still not growing back.
I have chronic migraine daily. Take Aimovig for 14 months. Migraine drops to 6 times per month. But my doc asks me to stop as a trail according to the protocol. Nightmares come. Daily migraine come back and worsen than before even resume 70mg injection twice. Up to 140mg with terrible attack for a day. No improvement then. Anybody encounter the same experience.
I am on Ajovy, six months now, It has cut my migraines from 20 a month to below 10. I am overjoyed. Topamax was kiling me before hand.
I just injected my 2nd monthly Emgality shot tonight. I’m currently experiencing insomnia, but that could be a result of the 3 day migraine I’ve been battling. I went from my migraines being well controlled for years (got maybe 1-2 a month and not super severe) to them being completely out of control in January. Constant eye pain, moderate to debilitating pain 3-5 days a week, constant fatigue, light sensitivity, and difficulty regulating my body temp. Found a headache appreciate neurologist when my Fioricet ran out. First we tried a nerve block (which caused a low grade constant pain in my greater occipital nerve for about 3 months, at we didn’t do that again). Then Botox (which has helped with my neck and shoulder tension significantly) and Nurtec (which made me puke). Traded Nurtec for Ubrelvy and it seems to help. Every new treatment has reduced the pain severity, but not the frequency of other symptoms. We finally tried Emgality 3 months ago. It’s too soon to really tell if it will work well. The Botox brought the pain during a migraine from an 8-9 to about a 6-7, with a pretty consistent 5 all the time. Emgality send to have brought the pain down further to a 2-3 constant, up to a 5 during an attack. I am getting silent migraines now, though. Nothing has helped lessen the frequent fatigue, light and sound sensitivity, brain fog, and now the new and different symptom of vertigo. I had similar results when I took Topamax years and years ago, only Emgality doesn’t make me stupid! My doctor is going to evaluate me next month and we may try a different one to see if it helps with the rest of the symptoms. I have an ADA accommodation with my work for migraine related absences, but it’s exciting next month, and I don’t know if they will let me renew it.
I am a 53 yr old woman. Having migraines since many decades. Take Zomig which mostly helps. Sometimes the attack gets out of control and have to take injections for painkillers. Last year took aimovig over three months. Other than constipation saw no difference at all. Doctor himself advised to discontinue. My questions are 1. Should I try emigality ? I’m worried about hair loss and weight gain issues of emigality 2. Could my increase in migraine since last year be due to menopause? Anyone noticed a spike after menopause ?
Been taking Aimovig 140 for 18 months and it saved my life. Went from 12-15 a month to 2-3 day migraine towards end of month.
Amazing!!
On the other hand hair loss, is noticeable. I normally have a full head of thick curly locks. I now have half of it and its limp and thin.
I love having my life back…I just didn’t want to have to sacrifice my hair for it. 😭 tough trade for me
3 to 4 migraines a month
Was taking topiramate daily and sumatriptan as needed. I struggled on my job because topiramate makes you fuzzy/cloudy/ searching for words and or thoughts. Oh sumatriptan makes you nauseated and after the A migraine episode he usually takes about two days to recover and feel back to normal. So now I started / injected 2 EMGALITY started on December 23, 2020 and today is December 27 and I am itching like crazy I also noticed that my hot flashes are more often than before. After reading the hair loss I’m a little worried because I don’t have that much hair. After speaking with the pharmacist he was only aware of redness around the area of the shot and suggested that I might be having an allergic reaction and I needed to speak to my Doc. First thing Monday she will be hearing from me.
Those side effects could not be related to EMGALITY. Read the label & FDU resource. The drug doesn’t have a single side effect. Efficiency shows its the most effective and fastest working CGRP
OMG! I had my first injection (2-120 mg each) on Dec. 29, 2021. I have been itchy, and having hot flashes. The first day my cheeks were really red and I was hot. I’ve been having trouble sleeping and that’s unusual for me.
“Those side effects could not be related to EMGALITY” – MY @SS, Doctor!! Emgality works by blocking CGRP. Perhaps this patient could be experience side effects due to the blocking of CGRP. It does MORE THAN simply cause excruciating pain when we experience the “classic migraine headache” attacks. In my case, I experienced overall fatigue and worsening pain, an uptick in migraine (not great when one is already chronic with over 20 days of migraine) and a near great inability to regular body temperature. I was constantly having to add or subtract clothing, fan myself, drink water, grab blankets and then ice bags, etc. to help as I would go from freezing cold to insanely hot in near impossibly short time frames. The ONLY explanation was the EMGALITY and it stopped once my neurologist removed me from that drug.
With Ajovy,why can’t you use 3 auto-guess instead of 3 syringes of you want to do the quarterly amounts?
I have been on ajovy for about 6 months now. Going from not working being bedridden to now being a GM of a restaurant and working alot. This drug has really saved me. I get itching from injection site first few months itching was really bad. I now inject on my upper thigh on the outside and the itching is less. All medications have side effects its a personal issue with what your willing to deal with. Ajovy has gotten me off opioids and forced. Hair loss can be a side affect of going off those meds. I’m willing to put up with up some hair loss for migraine relief. I have been feeling more sore and tired lately thought my fibro was getting worse. I have read people saying ajovy caused them body pain thought maybe was medication but turns out I now have arthritis which is causing the pain not the ajovy. I’m sticking with it. One thing I notice is few days in between ill get a small migraine but still less extreme than before.
I’ve had migraines 7d/wk for the past 20 years. Tried Aimovig for 3 mos….no help. Been on Emgality for 7 mos and the severity of the headaches have decreased slightly. But the week leading up to injection time, they get more intense. I think I need to be on a dose every two weeks.
Adding to my previous comment: Aimovig was never effective the first few days after injecting nor was it effective the week before the next injection. I suspect that the proper dosage for some is every 20 days rather than every 30 days.
Was on Aimovig 140mg for about a year for chronic daily migraines which started decades ago. It originally reduced my triptan usage from twice a day to once a day plus a few days a month without a migraine. Also, lower doses of triptans became effective. Side effects were: 1 – severe constipation treated effectively by Mirilax every other day. 2 – increase in vestibular migraines during first several months of usage. Aimovig slowly stopped working after about 5 months and lost all effectiveness by 12 months. Side effect of constipation remained even as Aimovig stopped preventing migraines.
Started emgality in June. Headaches have not decreased in quantity but intensity. In that regard, it’s great. Had hoped that s/e the 1st month would decrease with subsequent lower doses. Most did-insomnia, hot flashes-decreased. Constipation became constant. Facing 3rd injection after a month of fluid retention (not severe) and shortness of breath with mild exertion, and it seems s/e from other formulas are only worse. Hair loss- I can’t really judge. I have very thick hair and do see strands in shower but not clumps.
Although anecdotal evidence is often dismissed,since FDA did not bother to require intensive testing,it’s all we’ve got to judge by. Personal experiences are fairly consistant-can cause hair loss, constipation, peripheral edema, shortness of breath and anxiety- OR work perfectly. It is important to not dismiss any occurrences.
Constipation is not possible with Emgality, it attached to the receptor where you will find a lot of constipation with Aimovig because it blocks the receptor. Hair loss is also not possible due to this with Emgality. Good luck
I am using Amitriptyline and Emgality. I suffered since I was a teenager and I am now 50. I never realized I had them daily until I started just a few years ago on Amitriptyline. A few days a year I felt weird. Like I was ok, I felt ok… I didn’t know what I different or what was wrong or why but I wanted to figure out what I did different that day. . I never understood why everyone else could act the way they did. Finally a few years ago I was put on Amitriptyline. I was sick and tired of the multitude of Excederin, Xanax and opioids. (You should have seen how I scrounged around to find and stash narcs… just like a squirrel with nuts) I did so good on the Amitriptyline except for my worst ones.. monthly. It was like I was in labor dilated to 8. The pain was so intense like contractions! Knowing that Amitriptyline was out there and could work, I threw a temper tantrum for about a year just to document everything and to push for anything else that might work. I was afraid to try things at the same time because through the years I have felt like a ginny pig. Try this, try that, if you ask for pain killers you are an addict… I had had it. I was getting nausea from the large quantities of Excedrin and Tramadol and xanax I was taking not even touching some of the pain I had some days. My doc said to try Emgality and after hesitation I did. I have not had a migraine in 3 months. It was a fight with my insurance which was worth the fight but frustrating to endure. I now understand how people can wake up and feel fine and get to work with out a struggle. Its pretty easy now. I have always worked 2.5 full time jobs and it is now easy. It was easier to just keep moving when I had them because if I stopped moving I would feel them more. Anyway, I hope others find relief!
I too have struggled with migraine headaches since my teens and am almost 55 now. I’m having the worst batch of headaches I can remember since my twenties and have taken my first dose of this shot. I’m glad it’s working for you because I’m not having the same experience. I’m having the hot flashes and constipation others describe along with a daily low ebbing throb of headache that only dims with exercise or after eating a meal free of the things that can trigger headaches of course. I can tell you I also have that feeling of weirdness and working feverishly to keep busy helping quell the ever present anxiety. If you need help paying for this drug there is a emgality savings card, just text INFO to 55900 to download and activate the savings card. I hope this treatment continues to work for you, I will not be taking a second dose barring a miraculous improvement.
I took Aimovig for 4 months and it was great ! The 1st month I was down to 2-4 migraines and those were easy to treat. Month 3 i started having horrible back and upper thigh pain. I stopped Aimovig and within 2 weeks the pain was gone and has not returned. I’m really worried about trying a different one.
I’ve been on Emgality for about 4 months and unfortunately no improvements. Will try one more month before quitting. Have chronic daily migraine, no days without pain and symptoms. Now that I no longer have access to opioids for pain reduction (cut off like many others), I’m desperate for relief. Hoping something else works for me some day.
I had a year of Aimovig for free when it first came to market and it was a miracle cure for me. I have severe chronic migraine – daily. I used to only have a few days in a month without a migraine. Aimovig flipped this to where I was migraine free except for 2-3 mild migraines a month. I was on 140mg and never had side effects – which is unheard of for me. Im the type that gets the side effect that only effects 1% of users no matter what drug it is. I got laid off last year and lost my health insurance so the daily migraines returned. I was lucky to acquire 3 free sample of the medicine from another doctor of mine which gave me a 3 month period being pain free. I got medicaid and a new neurologist who prescribed the Aimovig. Got 1 dose. Now my insurance switched their policy and wont cover it but will cover the Emgality. So I will try it and hoping it works just as well and with little to no side effects. After reading some reviews I’m a bit worried about weight gain and hair loss as I’ve suffered from those side effects from other type of medications. Those two are deal breakers for me. But I’m gonna be optimistic!
I had hair loss and constipation with Aimovig and haven’t had any side effects at all with Emgality. It works differently, blocking the peptide rather than the receptor. Here’s hoping you have even better results with Emgality!
Began taking Emgality last May, 2019. Went from taking 5 Fiorinal a day to 3. In late February began experiencing hair loss. Would it take nearly a year to see this type of side effect?
Due die 8 dose Aimovig. Deciding whether or not to continue. First 3months showed improvement, could tell it was wearing off a while before next injection. Experience silent migraines, vestibular migraines w/severe dizziness, & migraines that hit be hard w/no warning, sharp knife pains in head. Wondering if all these CRGP drugs aren’t the same. I don’t get it free or for $5 copay. Conondrum!!
In the last few years I have tried a lot of therapies (Vitamine B2, Magnesium, electro stimulation, beta blockers, cardio training, antidepressants etc.) with little effect.
I started Aimovig in November 2019, and it reduced the frequency of my migraine attacks by 60% (from 10 to 4 per month). When I started daily cardio training in March the frequency dropped even to 2 per month, I hope it stays that way. I don’t suffer any side effects from Aimovig. You could control constipation with more magnesium, though.
By the way, work out with weights is increasing my migraine attacks.
Aimovig worked great for me as a preventative, however, it made me so nauseous 24/7 that I couldn’t function. I changed to Emgality. no nausea but a little too early to tell the efficacy.
I have been on Aimovig for over a year & at first it helped cut down on my chronic migraines. It seems to wear off after 3 weeks. I have Lupus & it seems to not be a good fit for those with Lupus. I’m going to talk to my doctor tomorrow about trying one of the others. I have noticed hair loss, but it could be due to other conditions as well. My chronic migraines are a result of a TBI, so I don’t know if any of these will have lasting results.
I have taken Aimovig for the last year. I have been in the ER for heart racing. I have also noticed my immune system is not good. I catch everything going around has anyone had these symptoms?
None of these medication provide assistance programs for those of us on Medicare due to the disability. When will these drug companies get with the program!
That’s not exactly true. Both Aimovig and Emgality have assistance programs for people on Medicare or Medicaid. Please see Affordable Access to Migraine Treatments and Strategies for Accessing CGRP Blocking Migraine Treatments to learn more.
This has been my experience. Retired , medicare advantage . Cost of meds add up quickly. My copay stopped 6 mon. In on taking Aimovig. Kickback program prevented drug co from helping with the price of aimovig. Application to the foundation was ridiculous and denied for filing errors.(?) back to repeated migraines for 6 mo until the new year . So now I get to repeat this hell. I’m tempted to inject every other month and hoard the medication.
Have been on Ajovy for the last year and it has worked amazingly well for me! Didn’t have to pay anything because of manufacturer coupon. New insurance doesn’t cover Ajovy, so I’m worried about trying another type. I have had absolutely no side effects and went from 11 migraines/mo to 2-3. Life changing. I don’t inject myself, but go to my neuro office and they do it for me. Can get 3 month dose at one time. The only bad thing is that the actual injection burns when being injected. Small price to pay for a miracle drug!
No hair loss on Emgality, but I am going off because I have severe sore throat for the past 3 months after injection. Injection site very reddened, even when I ice injection site beforehand. Emgality is a miracle. I am going to try Ajovy to see if the throat thing does not occur.
Stopped Emgality because it did not reduce or prevent migraine with aura after 6 months of treatments. Additionally, I experienced significant hair loss after each dose.
I started Aimovig in August 2018 -it took 3 mos to work. It stopped working in May 1019. I next will try Emgality
So far I’ve only tried Emgality for my 28 + years of chronic migraines. Mine began after TBI in the 1st Gulf War, so I’m not sure any of these meds will help. 3 months in and I’m stopping Emgality. No reduction in headaches, in fact a slight increase; now up to 27 or 28 days / month. Side effects of extreme fatigue, extreme swings in body temperature – hot flashes, night sweats and then extremely cold. Co-morbidity with fibromyalgia and that pain level has shot through the roof. Overall not a great first experience with CGRP inhibitors.
I also got night sweats and hot flashes daily since I took my first emgality shot 3 weeks ago, as well as daily dizziness and/or nausea which I didn’t have before. I haven’t noticed a change in the frequency of the migraines while on Emgality, but they’re slightly less painful. It’s not worth it to me to continue Emgality. I think they haven’t studied the side effects enough.
Has anyone taken any other types of drugs like zomig when you are on any of the once a month shots when you do get a migraine, Thanks Jamie
James,
There are three categories of treatments that most people with Migraine need:
Preventives are treatments that reduce the number of attacks and their severity. These new CGRP blockers are in the preventive category.
Most people with Migraine will still have attacks while on a preventive, just not as many (hopefully). So, we all need treatments to stop attacks when they happen. You mentioned Zomig, which is one of many medications in the “abortive” category. All triptans (Zomig, Imitrex, Axert, Relpax, Maxalt, Amerge, and Frova) are abortives. DHE, Cafergot, and Migranal are also abortives.
Then there’s a third category: rescue treatments. These are medications we can use when our abortives fail (which happens sometimes to all of us). These medications are designed to keep us out of the ER. They don’t always work, but when they do, we can rest comfortably at home instead of dealing with a busy, loud emergency room. Some common rescue treatments are: anti-nausea medications (Compazine, Phenergan, Reglan, Zofran), prescription NSAIDs (Toradol, Voltaren, Motrin), barbiturates (Fioricet, Fiorinal), or (in severe cases) opioids (Demerol, Vicodin, Percocet, hydrocodone, etc.).
Here are a few links that will explain all of this in greater detail:
Preventive, Abortive, & Rescue Migraine Treatments
A Plethora of Migraine Preventive Treatment Options
Going to the ER for Migraine Is Not the Best Choice
No constipation on emgality and it works faster than the others
I have been in the Amgen study for Aimovig for about 5 years and have been on the drug for about the last 3 years. This drug has given me my life back! I can’t say enough positive things about it. I have no side effects, but I may get 1 migraine every 2-3 months (no drug can completely prevent them) still is better than at least 1 migraine per week which is what I was experiencing before I started the trial. Obviously, it may not work for everyone, but ask you doctor if it may work for you. Give it a try. I’m concluding the study now and my insurance doesn’t cover it so I’m going to try the access card option that Amgen offers and see how that goes.
Very frustrated. I have had migraines for 5 years that had me bedridden. I may have had 3 or 4 days a month headache free. Started Aimovig in October 2018. It was a miracle drug for me! Got me down to 2 or 3 migraines a month. Has worked well with no side effects. Now my insurance company is trying to make me try Ajovy or Emgality. Medicine is not a one size fits all! If they are all the same price, why should the insurance company care which one I take? And on top of that they have not paid for one dose! I have gotten it free from Aimovig since I began taking it. I am extremely tired of the insurance companies thinking they know better than the doctors!
Jeannie
I have been taken adjovy for 4 months now and I love it so much, I’ve had Migraines since I was 10 years old I started this med and I love it ,I think it’s amazing the only side effect that I have is right on the shot the spot where I take the injection I get a reaction , beside that am happy now! I usually get about 15/20 headaches a month and now am down to 2.I do say when I get one is stronger then ever.
I have chronic silent migraine which means constant dizziness , pounding, tremors , imbalance and nausea . I had one shot of Aimovig which did nothing and I m having great difficulty in coping , am practically housebound . Can anyone help? Thanks
I have been on Aimovig 140 for 3 months and it has been a miracle drug for me. Nothing has worked in the past until this. I am still in disbelief. My only side effect is constipation.
I have been on Aimovig 140 for 2 years. It was miracle drug! I went from having a headache everyday to having 1-2 migraines a month. I had my life back. It has stopped working and I now have daily headaches and back to my weekly migraines. I am heart broken. I am giving it another month to see if maybe stress is making them ramp up. My Dr is going to try Ajovy . Maybe I just have become resistant to Aimovig. So sad …….
My experience so far. Have had chronic migraines for 12 years. Was taking nortriptylene as daily preventative. Have tried a long list of other preventatives and rescue meds, as well as the Botox treatment. None were effective for me. Nortriptylene kept headaches at a manageable level but the severe fatigue was getting unbearable. Tried Aimovig. Started with 70mg dose as I weaned myself off the nortriptylene. Seemed to be going ok for first 3 months. Then headaches started returning. Increased dose to 140mg and got sick right away. Major migraine and nausea for a couple of weeks. Went back on nortriptylene to get headaches under control. At the end of the month tried to go back down to the 70mg dose but headaches persist. I think I’m done with Aimovig now. Planning to try Emgality next.
I started Aimovig last September (I was on the assistance program with 0 copay) and noticed a significant reduction in the severity of the migraines (pain level from 8 down to 2 and 3-4 per week) after my first set of injections (I am taking 140mg/month). The frequency reduced to only 2-4 migraines per month after 3 months. I have continued to have the silent migraines and either Fioricet or the triptans help depending on how soon I realize what’s going on. The only side effect I had was the constipation. I started noticing that the migraines were coming back in January. They started to build about 2-1/2 weeks after the injection and I had to take the triptans because the pain was between 4-7. I asked my dr about possibly taking one injection of 70mg every 2 or so weeks and she thought that would be fine but my insurance won’t cover Aimovig until I try something else and they recommend I try Ajovy. I haven’t taken the Aimovig for April and surprisingly I haven’t had many bad migraines (only about 7 at a level 5) since my last injections in March. I haven’t noticed any hair loss, but I have been slowly losing my hair for years. While these are all new on the market and there are still things we are learning about them, I believe it’s like any medication…it will work for some but not all and regardless of the known side effects, it will effect us all in different ways due to our body chemistry. I highly recommend talking to your doctor if you have side effects that are not known. Also, I found a migraine journal app (Migraine Buddy by Healint) that has been a great help in tracking them. Hopefully, some day, we will know more about migraines and can get better meds. Aimovig, Ajovy and Emgality are a step in the right direction.
I am taking Aimovig and the first two months were good (I am experiencing the silent migraines others have spoken about). However, 3rd month was terrible. My doctor suggested the increase from 70 to 140. Wondering if it’s worth it or I should try Emgality. Has anyone increased the Aimovig and had success?
I was on Emgality for several months and the reduction in migraine was outstanding. I was down to one a month, which is miraculous considering I used to get 5 to 7 a week. My insurance plan covers only Aimovig, so I started Aimovig several months ago and am not pleased with the efficacy in my case. I now have gone to daily severe headache and neck muscle tightness, along with the constipation many complain about. So, I am going back to Emgality and pay the piper, so to speak, as I don’t have commercial insurance that will allow free or low co-pays. Nonetheless, migraine free is worth the costs.
Your story parallels mine exactly. Going to CVS today to pay $630 for an Emgality pen. Haven’t tried Ajovy yet but I don’t like the idea of putting a needle into my body. I’ll wait until the pen comes out. I also discovered that steroid trigger point injections in my neck worked wonders! – at least for about 6 weeks. You can’t do it too often but I had a glorious month of very little pain. Wow!
I am about to take my first dose of Emgality after having been on Aimovig for about six months. The Aimovig seemed to stop working and actually made my headaches worse. Anyway, my point of replying is that I have signed up for 12 months for the Amgality free. Have you tried to do that?
Not sure if any of you experiencing hair loss have stopped using opioid pain medication in the months prior, but that’s what happened to me. I was in pain meds and stopped them completely, just to have my hair start falling out in clumps about 4 months later. I was so scared and would cry. I didn’t lose it all or anything remotely close to it, but it was scary. My body went through shock, I guess. Anyhow, that was my experience. It wasn’t a new medication, it was stopping the old ones!
so what have you done? anyupdates?
I have tried all three of them and the Emgality seems to be working the best. My headaches are not breaking through as before and seem better controlled. I have chronic daily migraines so they are not gone completely but there seems to be some improvement. Aimovig made me very constipated and stayed with me for a month after stopping the shot. I hope there is more improvement as the months go on.
Emgality- HAIR LOSS. Significant side effects along with relief. Fewer migraines and reduced intensity, offset by many silent migraines, digestive changes and major hair loss.
Clumps and thinning, especially with loading dose. In addition, fatigue and strange out of body feeling. Reduction in pain in exercise- not a positive.
Given alarming concerns about long term side effects may tip me giving up.
I do not believe Emgality could possibly be associated with hair loss. It attached and infuses on the CGRP receptor. Please look into any other medications you’re taking. Good luck!
I’ve completed 6 months on Aimovig 70mg, just took 7th shot. I’m not sure it’s making much difference. I’ve had migraines daily or near daily (24-31 days a month) for 20 years, with an occasional 16-18 day month. I began Aimovig last Sept. No change until 3rd dose Nov, when I had only 16 days and used less triptans. I was so excited! I experienced a few “silent migraines” that month that Leanne here describes. Then Dec. I was daily again, maybe less triptans. Jan only17 mig days and less triptans. Feb was daily again, 26 out of 28 days. March was every single day until 3 days ago when I finally got a 2 day break. (Today is March 19,2019). I’m not sure if this is any different than pre-Aimovig, but I see Doc in April. Hoping they’ll up the dose to 140 or change it to another CGRP. Has anyone seen a difference between the 70 and 140? I know we are all different and respond to different things.
I have been taking Aimovig for approximately 4 months now. I am very happy with the results. I am down from 3 to 4 headaches a week to 3 to 4 a month. The only side effect (if that’s what it is) is called a silent migraine which I never had before. I had to search the web because I wasn’t sure what I was experiencing. Apparently it’s a migraine without the pain but you still experience some or all of the other symptoms of a migraine. It’s a very strange experience. I have had 2 silent migraines since starting Aimovig (I think) but I am still thrilled for not having the Migraines as often and the pain that goes along with them. I would highly recommend Aimovig. I still inject my sumatriptan shots when I get a migraine.
Ive experienced hairloss in my 4th month, have you?
I am on my 4th and hair loss is insane! 140 mg aimovig.
Ajovy has been a miracle for me. I feel like I’ve found the head transplant I’ve always half-jokingly said I wanted. I can easily tell when the 30 days is up and my old head starts coming back to life.
Yes Sarah. I did 4 months of AIMOVIG and had MAJOR hair loss in clumps!! Continuously! I’m horrified. Plus severe anxious, nervous, heart palpitations, shakiness/trembling symptoms for a couple of weeks after each injection. Terrible joint pain. Insomnia. And it made my migraines MORE severe and still constant.
Switched to Emgality 2 months ago. No bad side effects but continued hair loss! Not sure if it’s the Aimovig still in my system or if ALL these CGRP meds have balding as an unlisted side effect! Who would take them if they listed “Hair Loss” as a known side effect? Emgality didn’t make my migraines worse but there’s not substantial improvement to justify possible continued hair loss. So I’m stopping it too. Done with all of them.
To “Z” (and Sarah, who asked the question about hair loss…. I’m not a doctor but I’ve read all the studies on CGRPs, and hair loss is NOT a side effect. The only S/E’s these drugs have are possible irritation at the injection site and constipation, only with Aimovig. This is what makes them so attractive when compared to the horrible S/E’s of the other preventives. There are many different reasons for hair loss, and most have nothing to do with medications. Some are related to illness. I know this first hand. I had the same thing. I mean huge clumps of hair coming out and it lasted for 9 or 10 months. I was afraid I’d go bald. It finally stopped, but my hair is much thinner. This was about 7 years ago. I know how you feel, and it’s very scary.
Please go see a dermatologist who can diagnose the cause for your hair loss, and don’t just assume it is from the AImovig. My hair loss began at a time when I had started a new medication, and I wondered if that was the cause. But I chose to see a dermatologist and was diagnosed with something that had nothing to do with meds. The timing was just coincidental. I suspect that’s what you are experiencing.
If you were getting any relief from the Aimovig, I just encourage you to stay on it, or get back on, and seek out a dermatologist to find out the reason your hair loss. Don’t just assume it’s the drug and stop. Chances are, it is related to something else, and the sooner you get a diagnosis the sooner you will feel better about it.
Hair loss is definitely a side effect! When a drug is first introduced, all side effects are not known. Now that it is actually on the market and more people are using it, hair loss is absolutely a side effect. My daughter had hair loss from Aimovig. Not so much from Ajovy, but she had to stop that too because she had itching that became severe by the 4th injection. It’s a shame because it helped her migraines SO MUCH. I am wondering if Emgality would have the same effect on her.
I agree 100% with the hair loss issues. I’ve used Aimovig since last November and that’s the only change in my meds. In fact, I’ve tapered off of one drug because of the injections, so there is no other explanation
. It’s sad that you have to choose between hair loss and migraine relief. There has to be a better way.
Do any of the migraine injections cause hair loss or thinning?
This is the best time to be a CH or Migraine sufferer. So much medical progress leading the way to several possible relief options
Not sure any time is the best time to be a migraine sufferer, but I get your point lol…
Agree… it’s never a good time to get migraine however, I’ve been taking aimovig for 5 months now. My migraine frequency has reduced to approx 2-3 per month vs 3-4 per week. Yes, constipation has been a side effect but it is so worth have less migraines.