Ajovy vs. Emgality
See how Ajovy and Emgality compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both Ajovy and Emgality are injectable CGRP antibodies for migraine prevention, but Ajovy can be dosed once every 3 months while Emgality is only dosed monthly.
Emgality is also approved to prevent episodic cluster headache, a use Ajovy does not have, while Ajovy is approved for adolescents with episodic migraine and Emgality is not.
Injection site reactions are reported more often with Ajovy (up to 45%) than with Emgality (up to 18%), though both carry similar warnings about hypersensitivity and Raynaud's phenomenon.
Ajovy vs. Emgality Drug Summary
Ajovy
Ajovy (fremanezumab-vfrm) is a CGRP monoclonal antibody used to prevent migraine in adults and in adolescents ages 6 to 17 who weigh at least 45 kg. It is delivered through a prefilled syringe or autoinjector, given either once a month or once every 3 months.
Emgality
Emgality (galcanezumab-gnlm) is a CGRP monoclonal antibody used to prevent migraine in adults and to treat episodic cluster headache. It is given as a once-monthly subcutaneous injection, starting with a loading dose on day one.
Ajovy vs. Emgality Side Effects
Ajovy
Emgality
Ajovy vs. Emgality Dosage
Ajovy
Emgality
| 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 |
| 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 |
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 |
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 |
Ajovy vs. Emgality Indications
Ajovy
Ajovy is FDA-approved to prevent migraine attacks in adults and in adolescents ages 6 to 17 who weigh at least 45 kg. It is not approved to treat a migraine attack that has already started or for children under 6 or under 45 kg.
Prevents chronic and episodic migraine in adults
Approved for adolescents 6 to 17 (45 kg or more) with episodic migraine
Not approved for treating an active migraine attack
Not approved for children under 6 or under 45 kg
Emgality
Emgality is FDA-approved to prevent migraine in adults and to reduce the frequency of episodic cluster headache attacks in adults. It is not approved for use in anyone under 18 or for treating a migraine attack once it starts.
Prevents chronic and episodic migraine in adults
Also approved to reduce episodic cluster headache attacks
Not approved for use in anyone under 18
Not approved for treating an active migraine attack
Ajovy vs. Emgality Pros and Cons
Ajovy
Ajovy stands out among CGRP antibodies for its quarterly dosing option, letting patients get as few as 4 injections a year instead of 12. It is also the only one of the two approved for adolescents with episodic migraine, though it is not approved for cluster headache prevention.
Pros
Offers a once-every-3-months dosing option, needing as few as 4 injections a year
Approved for adolescents 6 to 17 with episodic migraine, an age group Emgality does not cover
Long-standing safety record since its 2018 FDA approval
Cons
Injection site reactions are reported more often than with Emgality (up to 45% vs up to 18%)
Not approved for cluster headache prevention, unlike Emgality
No loading dose option, so full effect may build more gradually than with Emgality's day-one dose
Emgality
Emgality is the only CGRP antibody also approved to prevent episodic cluster headache attacks, a use Ajovy lacks. It requires monthly injections with no quarterly option, though its injection site reactions occur less often than Ajovy's.
Pros
Only CGRP antibody also shown to reduce frequency of episodic cluster headache attacks
Injection site reactions occur less often than with Ajovy (up to 18% vs up to 45%)
Starts with a loading dose on day one, which may build effect faster in the first month
Cons
No quarterly dosing option; needs a monthly injection indefinitely
Not approved for use in anyone under 18, unlike Ajovy
Starting the loading dose requires two separate injections on day one
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.