How Does This Medication Work What Will It Do For Me
Erenumab belongs to the class of medications called calcitonin gene-related peptide receptor antagonists. Erenumab is used to prevent migraine for adults who experience 4 or more migraine days each month.
This medication works by blocking the activity of a protein called calcitonin gene-related peptide. For people suffering a migraine attack, this protein is increased.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Tell The Healthcare Provider About All Medications Being Taken
Aimovig has few drug interactions. The FDA lists no significant drug interactions in Aimovigs official drug information. Even so, it is important to tell the prescribing healthcare provider about all medications and supplements being taken. To prevent severe constipation when taking Aimovig, the healthcare provider may need to know if you take certain drugs that slow down movement in the intestines, such as antidiarrheals or opioids.
How To Take Aimovig Sureclick Autoinjector
Use Aimovig Sureclick Autoinjector exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Erenumab is injected under the skin, usually once per month. A healthcare provider may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don’t understand all instructions.
Prepare your injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.
Each prefilled syringe or autoinjector is for one use only. Throw it away after one use, even if there is still medicine left inside.
Do not shake the syringe or autoinjector or you may ruin the medicine.
Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the form and strength your doctor prescribes.
Store erenumab in its original carton in the refrigerator, away from heat and light. Do not freeze.
Take the medicine out of the refrigerator and let it reach room temperature for 30 minutes before injecting your dose. Protect from sunlight. Do not heat the medicine in hot water or in a microwave.
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How Should I Use Aimovig
Use Aimovig exactly as directed by your healthcare provider. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Aimovig is injected under your skin one time each month. A healthcare provider may teach you how to properly use the medication by yourself.
If your healthcare provider prescribes the 70 mg dose for you, take one injection. If your healthcare provider prescribes the 140 mg dose for you, take two separate injections one after another, using a different prefilled autoinjector or prefilled syringe for each injection. If you want to use the same body site for the two separate injections, make sure the second injection it is not at the same spot you used for the first injection.
Read and carefully follow any Instructions for Use provided with your medicine. Do not use Aimovig if you don’t understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.
Prepare your Aimovig injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.
Each single-use prefilled syringe or autoinjector is for one use only. Throw it away after one use, even if there is still medicine left inside.
Do not shake the syringe or autoinjector or you may ruin the medicine.
Store Aimovig in its original carton in the refrigerator, away from heat and light. Do not freeze.
Can I Take Part In This Registry
You may be able to participate if you have been diagnosed with migraine, are currently pregnant, and:
- have taken Aimovig during the 16 weeks before your last menstrual period and/or any time during pregnancy, or
- have not taken Aimovig or any medication targeting the calcitonin gene-related peptide pathway, including Ajovy® and Emgality® , shortly before or during your pregnancy, and
- agree for you, your doctor and your babys doctor to provide information about your health, pregnancy, and delivery, and information on your babys health, to the registry team.
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If I Have A Baby Is She Or He At Risk Of Getting Migraine
There does not appear to be a clear reason why people develop migraine, but genetics, in addition to environmental and lifestyle factors, are thought to play a role. There is an increased chance of your child developing migraine if it runs in your family. Your child may develop the condition as he/she matures, but hopefully by that time research will have led to a greater understanding of migraine.5
Warning Disclaimer Use For Publication
WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.
If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.
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Is Aimovig A Biologic
Yes. Aimovig is a monoclonal antibody, which is a type of biologic. A biologic is a drug thats developed from biological material, rather than chemicals.
Because they interact with very specific immune system cells and proteins, biologics such as Aimovig are thought to have fewer side effects compared to drugs that affect a wider range of body systems, as other migraine drugs do.
How Is Aimovig Different From Other Migraine Drugs
Aimovig is different from most other migraine drugs because it was the first FDA-approved medication specifically made to prevent migraine headaches. Aimovig is part of a new class of drugs called calcitonin gene-related peptide antagonists.
Most other drugs used to prevent migraine headaches were actually developed for other reasons, such as treating seizures, high blood pressure, or depression. Many of these drugs are used off-label to prevent migraine headaches.
Being a monthly injection also makes Aimovig different from most other migraine prevention drugs. Most of these other drugs come as tablets or pills. Botox is an alternative drug that comes as an injection. However, it has to be given in a doctors office once every three months. You can give yourself injections of Aimovig at home.
And unlike most other migraine prevention drugs, Aimovig is a monoclonal antibody. This is a type of medication developed in a lab. Its made from immune system cells.
Monoclonal antibodies are broken down inside many different cells in the body. Other migraine prevention drugs are broken down by the liver. Because of this difference, monoclonal antibodies such as Aimovig tend to have fewer drug interactions than other medications used to prevent migraine headaches.
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General Information About The Safe And Effective Use Of Aimovig
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Aimovig for a condition for which it is not prescribed. Do not give Aimovig to other people, even if they have the same symptoms that you have. It can harm them. You can ask your pharmacist or healthcare provider for information about Aimovig that is written for healthcare professionals.
Dosage Forms And Strengths
Aimovig is a sterile, clear to opalescent, colorless to light yellow solution available as follows:
- Injection: 70 mg/mL in a single-dose prefilled SureClick® autoinjector
- Injection: 140 mg/mL in a single-dose prefilled SureClick® autoinjector
- Injection: 70 mg/mL in a single-dose prefilled syringe
- Injection: 140 mg/mL in a single-dose prefilled syringe
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Read The Instructions For Use Before Each Injection
Properly injecting the medicine not only ensures the maximum benefits from the medicine but also helps to prevent injection site reactions. For this reason, always read the illustrated instructions for use before any use of Aimovig. Even if you feel experienced at giving the injection, always refresh your memory by completely reading all the instructions before administering an injection.
Aimovig And High Blood Pressure
High blood pressure was not reported as a problem in clinical trials, but once the drug was approved, reports of hypertension were reported in high enough numbers for the FDA to issue a warning. Some cases of hypertension were severe enough to require hospitalization. This adverse effect is more likely to occur in people who already have high blood pressure or risk factors for high blood pressure. Problems with blood pressure can occur within seven days of an injection. The FDA recommends that people with high blood pressure or risk factors for high blood pressure monitor their blood pressure regularly while taking Aimovig.
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Risk Of Taking Topiramate While Pregnant
The use of topiramate, particularly during the first trimester, is linked to an increased risk of birth defects. According to a study published in the American Journal of Obstetrics and Gynecology, using topiramate while pregnant can increase the chance of an oral cleft in a baby. An oral cleft can include a cleft lip, and it may or may not include a cleft palate. Seizure medicines, in general, are also linked to congenital heart defects, urinary tract defects and neural tube defects. The greatest risk of birth defects appears to be when topiramate is combined with valproate, which is also an epilepsy drug. Taking topiramate while pregnant doesnt mean a baby will definitely be born with a defect, but the risks may be more significant than they would be otherwise. The higher the dose of topiramate used during pregnancy, the higher the risk of birth defects in some cases. However, if you are currently taking topiramate and you become pregnant, dont stop using it without first speaking to your doctor.
What Did Physicians And Patients Say About Trying Aimovig
However, these results improved with continued treatment over time, and many patients reported decreases in average migraine days by the sixth month. This indicates that it may take time before some people experience the full benefit.
We asked Dr. Rebecca Burch, Assistant Professor at Harvard Medical School and headache specialist at Brigham and Women’s Hospital to tell us about her patients’ experiences. “We are seeing that Aimovig is effective in most of our patients who try it. Early results from our clinic’s survey of patients who used Aimovig show that around 60-65% of patients experienced at least some benefit,” she said.
“What’s particularly impressive about this finding is that we are mostly prescribing Aimovig to patients who have tried and failed a number of other treatments. There are several unanswered questions, however, including whether this treatment response will be sustained over time,” said Dr. Burch. “We are seeing some patients for whom the benefit wears off, so we’ll have to study efficacy again after a period of time.”
A five-year open-label study showed that about 70% of the people participating said that Aimovig was still effective in reducing their monthly migraine days and need for acute treatments. Since so many people with migraine disease have struggled with preventive treatments wearing off after a few months, this is good news.
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Questions About Aimovigs Dosage
Heres a list of commonly asked questions related to Aimovigs dosage.
- What if I miss a dose of Aimovig? If you miss a dose of Aimovig, inject your missed dose as soon as you remember. Then youll take your next dose of Aimovig 1 month from the date you took the missed dose. For example, if you remembered to take your missed dose on the third of the month, youll take every dose after that on the third of the month. If you have questions about what to do when you miss a dose of Aimovig, talk with your doctor or pharmacist.
- Will I need to use Aimovig long term? If you and your doctor determine that Aimovig is safe and effective for you, its likely that youll take it long term.
- How long does Aimovig take to work? Aimovig starts working right away to prevent migraine headaches. But it may take several doses before you start having fewer migraine attacks.
- Should I take Aimovig with food? You can take Aimovig with food or without it.
Find answers to some commonly asked questions about Aimovig.
Triptans: Pharmacologic Properties And Mechanism Of Action
The 5-hydroxytryptamine agonists are effective for the acute management of migraines, but they do not prevent future attacks. In contrast to analgesics, the efficacy of triptans is due to the specifically targeted pathogenesis of migraine headaches. Migraine is considered a neurovascular disorder: the sensitization and activation of the trigeminal ganglia promote inflammation of the nerves supplying the meningeal blood vessels and in turn cause dilation of the blood vessel walls.4 Triptans alleviate migraines by binding to serotonin 5-HT1B/1D receptors, thereby leading to vasoconstriction and inhibition of neuronal inflammation.3,9 There are currently 6 triptans available in Canada: almotriptan, eletriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan. Although the first triptan has been on the market for more than 2 decades, there is a paucity of published evidence regarding the safety of triptans as a group in human pregnancy.
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Constipation With Serious Complications
Constipation with serious complications has been reported following the use of Aimovig in the postmarketing setting. There were cases that required hospitalization, including cases where surgery was necessary. In a majority of these cases, the onset of constipation was reported after the first dose of Aimovig however, patients have also presented with constipation later on in treatment. Aimovig was discontinued in most reported cases of constipation with serious complications. Constipation was one of the most common adverse reactions reported in clinical studies .
Monitor patients treated with Aimovig for severe constipation and manage as clinically appropriate . The concurrent use of medications associated with decreased gastrointestinal motility may increase the risk for more severe constipation and the potential for constipation-related complications.
How To Treat Patients For Migraine During Pregnancy
Its important for providers who treat women during their reproductive years to be aware of treatment options that are safe during pregnancy. Many women with migraine who are pregnant or considering pregnancy stop taking their migraine medications and assume they dont have safe treatment options availablebut this is simply not true.
Women typically start to experience migraine attacks during adolescence, which aligns with when menstruation begins. The highest incidence of migraine is between ages 18 and 44, which are also the year many women experience pregnancy. The rate of migraine among women is three times higher than it is for men. Because of these figures, it is believed that fluctuations in estrogen levels play a role in migraine development.
Dr. Tracy Grossman, an obstetrician-gynecologist who has completed a fellowship in maternal-fetal medicine and earned a masters in neuroscience, shares the range of treatment options available for pregnant patients with migraine.
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Abortive Treatment In Pregnancy
Pharmacologic Treatments
Acetaminophen is commonly used as an abortive agent for migraine and is considered safe during all trimesters of pregnancy. Acetominophen use is reported by 65% of pregnant women.35 There was some concern of an association between acetaminophen use during pregnancy and neurodevelopment effects, in children with more than 28 days in utero exposure .36 The European Medicines Agency, however, found the data for this association insufficient.37
Non-steroidal anti-inflammatory drugs , although commonly used for migraine treatment, have limited use in pregnancy. As prostaglandin synthetase inhibitors, NSAIDs can affect fetal development in a trimester-specific manner.38 Some studies have shown NSAID use in the first trimester leads to congenital malformations and miscarriages.38,39 A more recent study, however, evaluating the teratogenicity of NSAIDs in the first trimester did not find significant embryonic risk in women exposed to NSAIDs compared with women who were not exposed.40 In the third trimester, NSAID use should be avoided because of the known risk of premature ductus arteriosus closure and other adverse fetal outcomes.41
Metoclopramide is a preferred antiemetic during pregnancy with established safety in the treatment of hyperemesis gravidarum.42 The combination of parenteral diphenhydramine and metoclopramide is an effective migraine abortive when acetaminophen is not sufficient.43
Nerve Blocks
Neuromodulation
Treatment Options During Pregnancy
Certain medications used for migraine treatment and prevention are contraindicated for pregnancy, due to safety concerns for the developing fetus. For patients who use oral contraceptives to regulate their hormone levels and manage migraine, having a conversation about migraine treatment options may happen when they want to go off of birth control and start trying to conceive. The good news is there are safe options for migraine prior to and during pregnancy.
Im always telling my patients, either preconception or patients that are pregnant, that we recommend in general to use the number of different medications for anything that were treating, Dr. Grossman says. And also, of course, the lowest dose possible that we can use in pregnancy and preconception is what we recommend. Her first-line treatment is non-medication options, and she then layers in other treatments as needed.
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