Aimovig vs. Ajovy

See how Aimovig and Ajovy compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Aimovig and Ajovy are both CGRP-blocking monoclonal antibodies for migraine prevention, but Aimovig targets the CGRP receptor while Ajovy binds the CGRP protein itself.

  • Aimovig is injected once a month only, while Ajovy can be dosed monthly or once every three months, giving patients a scheduling option Aimovig does not offer.

  • Injection site reactions are far more common with Ajovy (38% to 45%) than with Aimovig (5-6%), though Aimovig carries its own postmarketing risk of severe constipation.

Aimovig vs. Ajovy Drug Summary

Aimovig

Aimovig (erenumab-aooe) is a monoclonal antibody that blocks the CGRP receptor to help prevent migraines before they start. It is approved for adults and given as one injection a month, at either 70 mg or 140 mg, using a prefilled autoinjector or syringe.

Ajovy

Ajovy (fremanezumab-vfrm) is a monoclonal antibody that binds the CGRP protein itself to prevent migraine in adults and some adolescents. It is injected either monthly at 225 mg or once every three months at 675 mg, using a prefilled syringe or autoinjector.

Aimovig vs. Ajovy Side Effects

Aimovig

Most common
Injection site reactions (5-6%)

Ajovy

Most common
Injection site reactions (38% to 45%)

Aimovig vs. Ajovy Dosage

Aimovig

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 70 mg once monthly At the start
Maximum dose 140 mg once monthly If needed
Dose changes 1 increase As tolerated

Ajovy

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 225 mg once monthly At the start
Maximum dose 675 mg every 3 months If needed
Dose changes 1 increase As tolerated

Aimovig vs. Ajovy Indications

Aimovig

Aimovig is FDA-approved to prevent migraine attacks in adults, whether episodic or chronic. It works by blocking the receptor for CGRP, a protein involved in triggering migraine pain. It is not approved to stop a migraine once an attack has already started.

  • Prevents episodic and chronic migraine in adults

  • Blocks the CGRP receptor directly

  • Not for treating an active migraine attack

  • Approved only for ages 18 and up

  • Self-injected once a month at home

Ajovy

Ajovy is FDA-approved to prevent migraine in adults and, unlike Aimovig, in adolescents ages 6 to 17 who weigh at least 45 kg. It works by binding to the CGRP protein itself rather than its receptor. It is not approved for stopping a migraine attack that has already begun.

  • Prevents episodic and chronic migraine in adults

  • Binds directly to the CGRP protein

  • Not for treating an active migraine attack

  • Approved for adolescents 6-17 weighing 45 kg+

  • Self-injected monthly or quarterly at home

Aimovig vs. Ajovy Pros and Cons

Aimovig

Aimovig has a simple, single monthly injection schedule with a well-established safety record since its 2018 approval. Its most common side effects, injection site reactions, constipation, and muscle cramps, occur far less often than the injection site reactions reported with Ajovy.

Pros

  • Available in two dose strengths (70 mg or 140 mg) for titration

  • Injection site reactions are far less common than with Ajovy

  • Only one injection needed per month, never multiple at once

Cons

  • No quarterly dosing option, so a monthly injection is required indefinitely

  • Not approved for adolescents, only for adults 18 and older

  • Postmarketing reports of constipation severe enough to require hospitalization or surgery

Ajovy

Ajovy stands out among CGRP migraine drugs by offering a quarterly injection option, letting patients switch between monthly and once-every-three-month dosing. Injection site reactions are its most common side effect and occur much more often than with Aimovig.

Pros

  • Offers a quarterly dosing schedule, cutting yearly injections from twelve to four

  • Approved for adolescents ages 6 to 17 weighing at least 45 kg

  • Long roughly 30-day half-life allows flexible dosing intervals

Cons

  • Injection site reactions are far more common, 38% to 45% versus 5-6% with Aimovig

  • The quarterly 675 mg dose requires three separate injections given at once

  • Only one monthly dose strength is available, limiting dose adjustment

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