Aimovig vs. Emgality
See how Aimovig and Emgality compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Aimovig and Emgality are both once-monthly injectable CGRP antibodies for migraine prevention, but only Emgality is also approved to treat episodic cluster headache.
Aimovig uses a simple flat monthly dose with no titration, while Emgality starts with a loading dose before switching to its regular monthly amount.
Emgality causes injection site reactions more often than Aimovig, based on each drug's own FDA trial data.
Aimovig vs. Emgality Drug Summary
Aimovig
Aimovig (erenumab-aooe) is a CGRP receptor-blocking monoclonal antibody used to prevent migraines in adults. It is given as a once-monthly subcutaneous injection at a fixed dose of 70 mg or 140 mg, with no titration required.
Emgality
Emgality (galcanezumab-gnlm) is a CGRP-targeting monoclonal antibody used to prevent migraines and treat episodic cluster headache in adults. It is given monthly by injection, starting with a 240 mg loading dose then dropping to a 120 mg maintenance dose.
Aimovig vs. Emgality Side Effects
Aimovig
Emgality
Aimovig vs. Emgality Dosage
Aimovig
Emgality
| 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 | 240 mg loading dose | Day 1 |
| Maximum dose | 300 mg once monthly | If needed |
| Dose changes | 2 increases | 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 |
Emgality
| STAGE | DOSE | WHEN |
| Starting dose | 240 mg loading dose | Day 1 |
| Maximum dose | 300 mg once monthly | If needed |
| Dose changes | 2 increases | As tolerated |
Aimovig vs. Emgality Indications
Aimovig
Aimovig is FDA-approved only for the preventive treatment of migraine in adults. It reduces how often migraine attacks occur but does not treat an attack once it starts.
Chronic migraine prevention in adults
Episodic migraine prevention in adults
Once-monthly injection, fixed 70 mg or 140 mg dose
Not approved for acute migraine attacks
Emgality
Emgality is FDA-approved for migraine prevention and for treating episodic cluster headache in adults. It works the same way for both conditions but uses a higher dose for cluster headache than for migraine.
Chronic and episodic migraine prevention in adults
Episodic cluster headache treatment in adults
Once-monthly injection after initial loading dose
Not approved for acute migraine attacks
Aimovig vs. Emgality Pros and Cons
Aimovig
Aimovig's flat monthly dosing and lower rate of injection site reactions make it a straightforward option for migraine prevention. It has no loading dose, but it is not approved for cluster headache, so patients needing that indication will need a different medication.
Pros
Simple two-dose regimen (70 mg or 140 mg) with no titration
Lower rate of injection site reactions than Emgality (5-6% vs up to 18%)
First FDA-approved CGRP receptor-targeting monoclonal antibody
Available as autoinjector or prefilled syringe
Cons
Only approved for migraine prevention, not cluster headache
Postmarketing reports of severe constipation requiring hospitalization or surgery
No loading dose option if a faster preventive effect is desired
No generic or biosimilar version available
Emgality
Emgality covers a broader range of conditions, including episodic cluster headache, which Aimovig does not treat. Its loading dose and higher injection site reaction rate are trade-offs some patients weigh against that added flexibility.
Pros
Also approved for episodic cluster headache, unlike Aimovig
Delivered via prefilled pen designed for easy self-injection
Loading dose on day 1 may support faster onset of effect
No boxed warning on its FDA label
Cons
Higher rate of injection site reactions than Aimovig (up to 18% vs 5-6%)
Requires a loading dose before settling into a maintenance dose
Separate dosing schedules for migraine versus cluster headache
Not approved for use in patients under 18
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