Aimovig (Erenumab-aooe) - Subcutaneous

What Is Aimovig?

Aimovig (erenumab-aooe) is a U.S. Food and Drug Administration (FDA)-approved medication to prevent migraine headaches. It is injected under the skin (subcutaneously) once a month.

Aimovig is a biologic medication that can affect cells at the molecular level. It is more specifically referred to as a monoclonal antibody that targets a specific protein in the brain called calcitonin gene-related peptide (CGRP). CGRP is directly related to causing a migraine attack. Aimovig is an agent that blocks the receptor where this protein binds, preventing migraines.

What Is Aimovig Used For?

Aimovig prevents migraine headaches with a once-monthly injection. It is currently only used for adults dealing with occasional (episodic) or chronic migraines.

How to Take Aimovig

Take Aimovig as an injection under the skin of a fatty area, such as your stomach, upper back of the arms, or the thigh area. Follow these instructions when using the medication:

• If you store this medication in the refrigerator, take it out and leave it at room temperature for at least 30 minutes before injecting it to minimize pain.
• Inspect the medication for any color changes or particles before injecting.
• Do not inject it within two inches of the belly button.
• Throw away used needles in a needle/sharp disposal box or similar containers, like a milk jug.
• Do not use the device more than once, as each injection is meant for one-time use only.

It is best to speak with your healthcare provider before using this medication. They can provide detailed guidance on how to administer it before initial use.

Storage

Before its first use, store Aimovig in the refrigerator between 36 F and 46 F in its original packaging to protect it from the light. Once you remove it from the refrigerator, keep it at room temperature (between 68 F and 77 F) in its original packaging. You must use it within seven days if leaving it at room temperature. After seven days, discard the medication.

Do not store Aimovig in the freezer or the car if temperatures are not within the recommended refrigeration temperature.

Off-Label Uses

Aimovig is not FDA-approved to treat or prevent cluster headaches or other forms of migraines, such as vestibular migraines. However, if other medications fail, healthcare providers may prescribe Aimovig for these purposes. This is known as off-label use.

Aimovig and CGRP blockers are approved to prevent migraines. However, they may also help prevent cluster headaches.

Newer treatments like CGRP blockers for migraine headaches are currently being reviewed for treating vestibular migraines, which are associated with headaches that involve vertigo, dizziness, and balance disturbances. Further studies are needed, but these anti-CGRP medications have shown promise in treating multiple forms of migraine headaches.

What Are the Side Effects of Aimovig?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Aimovig include:

• Injection site reactions (e.g., redness, swelling, or itchiness)
• Constipation
• Cramps or muscle spasms

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include the following:

• Hypersensitivity reactions (e.g., rash, swelling of the face, and anaphylaxis)
• Constipation with severe complications, such as hospitalization
• High blood pressure, which can cause symptoms such as a bad headache, vision changes, or passing out

Long-Term Side Effects

Immunogenicity is a rare but serious side effect that can occur while taking monoclonal antibodies. Immunogenicity is the ability of a foreign substance, such as Aimovig, to provoke an immune response. This could render your medication ineffective or even cause more harm than good.

Dosage: How Much Amovig Should I Take?

Modifications

Certain factors may influence how your healthcare provider prescribes or doses your medication. The following are considerations for dosing adjustments as applied to Aimovig.

Children

The safety and efficacy of Aimovig in this population have not yet been fully established. Different treatments may need to be considered if your child is dealing with migraines.

People 65 Years and Older

Data on the use of Aimovig in older adults (65 and above) is limited. The general recommendation is to start at a lower dose. A healthcare provider may need to monitor liver, kidney, and heart function.

Missed Dose

If you miss your usual dose of monthly Aimovig, take it as soon as you remember to. After that, you may take your Aimovig once each month from the date of your most recent dose.

Overdose: What Happens If I Take Too Much Aimovig?

Aimovig should not be taken beyond what was prescribed by your healthcare provider. Since this medication is only given once a month, it is rare to overdose on it.

However, if you accidentally take more than prescribed, contact a healthcare provider immediately or dial 911 if you experience severe symptoms.

Precautions

What Are Reasons I Shouldn’t Take Aimovig?

Do not take Aimovig if you are allergic to its main ingredient, erenumab aooe. If you develop an allergic reaction while taking it, stop your medication as soon as possible.

What Other Medications Interact With Aimovig?

Aimovig is a relatively safe medication. It does not interact with many medications or common metabolites of the body, referred to as cytochrome P450 enzymes. These enzymes help break down drugs, toxins, and various chemical compounds.

There are currently no documented drug interactions with Aimovig. However, drugs associated with the same class or that have properties similar to the effect of a CGRP blocker should generally not be taken with Aimovig.

What Medications Are Similar?

Aimovig is a monoclonal antibody and CGRP blocker. Other medications that have effects similar to Aimovig include:

• Ajovy (fremanezumab-vfrm)
• Emgality (galcanezumab-gnlm)
• Vyepti (eptinezumab-jjmr)
• Nurtec ODT (rimegepant)
• Ubrelvy (ubrogepant)
  

How Can I Stay Healthy While Taking Aimovig?

Migraines can be an uncomfortable and debilitating condition. Getting ahead of your migraine attacks can help improve your quality of life. This can involve a combination of prescription medications, lifestyle changes, and other alternative medicine approaches.

Try to avoid migraine triggers. Migraine triggers can include:

• Bright lights
• Spending long amounts of time in front of a screen
• Stress and anxiety
• Irregular sleep
• Skipping meals
• Increased caffeine intake

Additionally, some people use complementary strategies, such as acupuncture or biofeedback training, and practices, such as yoga or meditation.

Talk to your healthcare team about other ways to prevent or manage migraine attacks.

The author would like to recognize and thank Jaycob Pena for contributing to this article.