Emgality (Galcanezumab-Gnlm) - Subcutaneous

What Is Emgality?

Emgality is a biologic drug belonging to a new class of drugs called calcitonin gene-related peptide (CGRP) antagonists. It contains the drug galcanezumab, a monoclonal antibody (a type of biological drug developed from immune system cells in a lab). It blocks the activity of specific proteins in the body.

CGRP antagonists drugs were explicitly designed to prevent migraine headaches. Emgality works by blocking the activity of the brain's calcitonin gene-related peptide (CGRP) protein involved in inflammation and vasodilation (widening of blood vessels). It blocks CGRP by binding to its receptor site.

It is a prescription drug available in injection form to be given subcutaneously (under the skin).

Drug Facts

Generic Name: Galcanezumab-Gnlm

Brand Name(s): Emgality 

Drug Availability: Prescription

Therapeutic Classification: Monoclonal antibodies

Available Generically: No

Controlled Substance: No

Administration Route: Subcutaneous

Active Ingredient: Galcanezumab-Gnlm

Dosage Form(s): Injection

What Is Emgality Used For?

Emgality is a medication option used for the following conditions in adults:

Migraines have recurring moderate to severe pain with throbbing or pulsing in the head. The pain is usually on one side of the head with other symptoms, such as nausea, weakness, and sensitivity to light and sound.

Researchers believe that migraine results from neurological differences caused by genetic mutations in the brain. There is no absolute cure for migraine at present. Currently, the clinical approaches prevent or relieve the symptoms during migraine attacks. Prevention involves the use of medications and behavioral changes.

How to Take Emgality?

Follow the guidelines on your prescription label and ask your healthcare provider about anything you don't understand.

  1. Emgality is available as a prefilled pen or injections to administer a dose. 
  2. The prefilled devices are used to give one single dose and are discarded afterward.
  3. Inject the dose subcutaneously (under the skin) on your thigh, back of your upper arm, buttocks, or stomach area.
  4. Don't inject in bruised, scaly, red, itchy, or broken skin.
  5. You will inject the first dose consisting of two or three injections of Emgality in the healthcare provider's office or at home. 
  6. Later, you will inject the following doses every month at home.
  7. Emgality injection is independent of the effect of food. You can inject it before or after a meal.
  8. Allow the Emgality injection or pen to warm to room temperature for 30 minutes before injecting the medication.
  9. Do not warm the medication by any method.
  10. Use the prefilled syringe or injection pen only once and inject all the solution.
  11. Discard used syringes or injection pens in a puncture-resistant container. Ensure the medicine solution is clear or colorless to a slightly yellow or brown solution.
  12. Do not use it if it is cloudy or contains flakes or solid particles. 
  13. Do not shake the Emgality pen or injection.

Ask for the manufacturer's label to read the instructions carefully on how to use it.

Storage

A few storage tips:

  • Store Emgality pre-filled pens in the refrigerator between 36°F to 46° Fahrenheit (F) (2°C to 8° Celsius (C)).
  • Do not freeze.
  • You may store Emgality out of the refrigerator for up to seven days at temperatures up to 86°F (30°C).
  • Once out of the refrigerator, do not place it back in the fridge.
  • Keep the medication in the original carton to protect it from light until you are ready to inject it.
  • Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the Food and Drug Administration's (FDA) website to find out where and how to discard unused, expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you plan to travel with Emgality, get familiar with your final destination's regulations. In general, be sure to make a copy of your Emgality prescription. If possible, keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

How Long Does Emgality Take to Work?

On average, the elimination half-life of Emgality was approximately 27 days. Emgality (galcanezumab) 120 milligrams (mg) monthly (with a 240 milligrams loading dose) begins reducing the days of migraine headaches on the first day after the first injection.

Off-Label Uses

Emgality is used off-label to treat vestibular migraine headaches. Ask your healthcare provider about the use of this drug.

What Are the Side Effects of Emagality?

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 side effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effect associated with Emgality:

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Serious side effects and their symptoms include:

  • Allergic reactions: Hives, rash, itching, trouble breathing or swallowing, shortness of breath
  • Immunologic reaction: When the body makes antibodies against Emgality (normal range: 5% to 13%; neutralizing range: ≥50%, which makes Emgality ineffective)

Report Side Effects

Emgality may cause other side effects. Call your healthcare provider if you have unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Emgality Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form (solution):
    • For episodic cluster headaches:
      • Adults—At first, 300 milligrams (mg) injected under the skin (given as three 100 mg injections in a row) at the start of a cluster headache. Then 300 mg injected under the skin once a month until the end of the cluster period.
      • Children—Use and dose must be determined by your doctor.
    • For migraine headaches:
      • Adults—At first, 240 milligrams (mg) injected under the skin as a loading dose (given as two 120 mg injections in a row). This is followed by 120 mg injected under the skin once a month.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Emgality:

Severe allergic reaction: Avoid using Emgality if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In rat and rabbit studies, Emgality administration during pregnancy and lactation did not have adverse effects on fetal development. There is not enough data about the safety and effectiveness of Emgality in pregnant people and their unborn fetuses. Discuss with your healthcare provider if you are pregnant or plan to become pregnant and weigh the benefits and risks of taking Emgality during your pregnancy.

Breastfeeding: There is not enough information about the safety and effectiveness of Emgality and its release in human breastmilk and nursing babies. Talk with your healthcare provider if you plan to breastfeed, weigh the benefits and risks of taking Emgality while nursing, and the different ways to feed your baby.

Adults over 65: Clinical studies haven't included a large enough number of people in this age group to see whether they respond differently from younger adults.

Children: Safety and effectiveness have not been established in children.

Administration modifications: Emgality should be used subcutaneously only.

Missed Dose

If you accidentally forgot your Emagality dose, take it as soon as you remember. Take the following dose next month at the scheduled date. Don't try to double up to make up for the missed dose.

Try to find ways that work for you to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Emgality might be less effective at treating or preventing migraine.

Overdose: What Happens If I Take Too Much Emgality?

In case of an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Emagality?

If you think you or someone else may have overdosed on Emgality, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Emagality, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

This medicine may cause serious allergic reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

What Are Reasons I Shouldn’t Take Emagality?

People with severe hypersensitivity to galcanezumab-gnlm or any of the other ingredients of this injection should not use Emaglaity.

Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

What Other Medications Interact With Emgality?

Talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs, or plant-based medicines, to avoid drug-drug interaction.

What Medications Are Similar?

Several drugs are used to treat and prevent migraine. Some of these are approved by the FDA, while others are used off-label by healthcare providers. However, calcitonin gene-related peptide (CGRP) blockers are a new drug class approved by the FDA to prevent migraine headaches.

The choice of drug will depend on your health condition and clinical requirements. Your healthcare provider will prescribe the best suitable medicine for you. 

Some of the common drugs approved to treat migraine headaches are:

Anti-seizure medications:

Beta-blockers:

Calcitonin gene-related peptide (CGRP) antagonists:

Neurotoxin:

Frequently Asked Questions

  • What is Emgality?

    Emgality contains the active drug galcanezumab-gnlm, a monoclonal antibody. It's used to prevent migraine headaches and symptoms of cluster headache. 

  • How Emgality works?

    Emgality blocks calcitonin gene-related peptide (CGRP) from binding to its receptor.

  • How is Emgality different from the drugs of its own class?

    Emgality was the third drug approved by the Food and Drug Administration (FDA) in a new class of drugs called calcitonin gene-related peptide (CGRP) blockers. Other CGRP antagonists are only approved for migraine prevention. However, unlike other drugs of this class, Emgality is also approved to treat cluster headaches.

  • How much does Emgality cost?

    Emgality does not have a generic alternative and is available only as a brand. It can be costly. However, if someone needs financial support to pay for Emgality, help is available.

    Eli Lilly and Company, the manufacturer of Emgality, offers a savings card that can help pay less for Emgality. For more information, visit the program website.

How Can I Stay Healthy While Taking Emgality?

Migraine is associated with cerebral nerve cells and blood vessel dysfunction. The migraine attack often begins when specific triggers, such as stress, foods, or hormonal changes, cause excessive relaxation or dilation of blood vessels in the brain. Living with migraine does have its challenges, but there are ways to help improve your quality of life. Refer below for some general tips to support your health:

  • Take medications as recommended by your healthcare provider to avoid relapsing migraine attacks.
  • Try to avoid your migraine triggers.
  • Achieve a healthy outcome to prevent worsening headaches and other symptoms.
  • Keep your doses regular and avoid skipping to get the maximum benefit from Emgality.
  • Emgality does not treat migraine, but it only helps to prevent the number of days you get it.
  • Don't stop taking it even if you feel better without asking your healthcare provider.
  • Emgality is different from other drugs of its class as it is the only drug used for acute episodic cluster headaches. Use the drug only for the condition prescribed.
  • Consider support groups or working with a healthcare provider to help you find coping strategies to change the way you think, feel, react, or respond to living with migraine.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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