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

Most common
Injection site reactions (5-6%)
Constipation (up to 3%)
Cramps (2%)
Muscle spasms (2%)

Emgality

Most common
Injection site reactions (18%)
Constipation (1.0% to 1.5%)
Injection site pain (10.1% to 11.6%)
Vertigo (0.7% to 1.2%)

Aimovig vs. Emgality 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

Emgality

Dosage
Dosage Table
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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