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
Ajovy
Aimovig vs. Ajovy Dosage
Aimovig
Ajovy
| 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 |
| 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
| 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
| 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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