Ajovy is a brand-name prescription medication that’s used to prevent migraine headaches in adults.

Drug details

Ajovy comes as a solution inside prefilled syringes and autoinjectors. It’s given as a subcutaneous injection.

You can self-inject Ajovy. Or, you can receive Ajovy injections from a healthcare professional in your doctor’s office. Ajovy can be injected monthly or quarterly (once every three months).

Ajovy contains the active drug ingredient fremanezumab-vfrm, which is a monoclonal antibody. A monoclonal antibody is a kind of drug that’s created from immune system cells.

Ajovy is a migraine medication that works by preventing some of your body’s proteins from functioning. Ajovy can be used to prevent both episodic and chronic migraine headaches.

A new kind of drug

Ajovy is part of a new class of drugs known as calcitonin gene-related peptide (CGRP) antagonists. These drugs are the first medications created to prevent migraine headaches.

The Food and Drug Administration (FDA) approved Ajovy in September 2018. Ajovy was the second drug in the CGRP antagonist class that the FDA approved to help prevent migraine headaches.

There are also other CGRP antagonists available. These include:

Effectiveness

To learn about the effectiveness of Ajovy, see the “Ajovy for migraine” section below.

Ajovy is available only as a brand-name medication. It’s not currently available in biosimilar form.

A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug). Ajovy is a biologic medication, which is also called a biologic.

Biologic drugs are made from living cells. It’s not possible to copy these drugs exactly. A generic, on the other hand, refers to drugs made from chemicals. A generic is an exact copy of the active drug in a brand-name medication.

Biosimilars are considered to be just as safe and effective as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.

Ajovy contains the drug fremanezumab, which is also called fremanezumab-vfrm. The reason “-vfrm” appears at the end of the name is to show that the drug is distinct from similar medications that may be created in the future. Other monoclonal antibodies are named in a similar way. In this article, we’ll refer to Ajovy’s active drug as fremanezumab.

Ajovy can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Ajovy. This list does not include all possible side effects.

For more information on the possible side effects of Ajovy, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of Ajovy are injection site reactions.

Injection site reactions

Injection site reactions can include the following effects at the site where you inject the drug:

Injection site reactions are usually not severe or long lasting. Many of these side effects may disappear within a couple of days or a few weeks.

In clinical trials, there wasn’t a significant difference in this side effect between people who took Ajovy monthly and those who took it once every three months.

Talk with your doctor or pharmacist if your side effects are severe or they don’t go away.

Serious side effects

It’s not common to have serious side effects from Ajovy, but it’s possible. The main serious side effect of Ajovy is a severe allergic reaction to the drug. See below for details.

Allergic reaction

As with most drugs, some people can experience an allergic reaction after they take Ajovy. It’s not known exactly how often this side effect occurred in the drug’s clinical studies. But it doesn’t appear to be common.

Symptoms of a mild allergic reaction may include:

Severe allergic reactions to Ajovy are rare. Possible symptoms of a severe allergic reaction include:

  • swelling of your tongue, mouth, or throat
  • angioedema (swelling under your skin, typically in your eyelids, lips, hands, or feet)
  • trouble breathing

If you have a severe allergic reaction to Ajovy, call your doctor right away. If your symptoms feel life threatening or if you think you’re having a medical emergency, call 911.

Long-term side effects

To date, long-term side effects haven’t been reported with Ajovy. Keep in mind that Ajovy is a recently approved medication in a new class of drugs. So, doctors are still learning about the drug’s potential to cause long-term side effects.

The longest clinical study (PS30) of Ajovy lasted 1 year. And people in this study didn’t report any serious or long-term side effects.

Here are answers to some frequently asked questions about Ajovy.

Are reviews available from people who’ve taken Ajovy?

The manufacturer of Ajovy provides patient stories from those who’ve taken this drug. To read the stories, see the manufacturer’s website.

Keep in mind that medications, including Ajovy, can affect people differently. Be sure to talk with your doctor about whether this drug is best for your condition.

Does Ajovy come in autoinjectors?

Yes, Ajovy is available in both autoinjectors and prefilled syringes.

The autoinjector and prefilled syringes both come in the same strength: 225 mg per 1.5 mL solution. Both of these are single-dose forms, meaning you’ll use a new autoinjector or prefilled syringe each time you take a dose.

For more information on the two forms of Ajovy, see “Drug forms and strengths” in the “Ajovy dosage” section below.

Can stopping Ajovy cause withdrawal symptoms?

Stopping Ajovy probably won’t cause withdrawal symptoms. However, you may be more likely to have a migraine episode if you stop taking Ajovy. (Keep in mind that Ajovy is used to help prevent migraine episodes.)

Withdrawal symptoms are side effects that can happen if you suddenly stop taking a medication that your body has become dependent on. (With dependence, your body needs a medication in order to function like usual.) But withdrawal symptoms weren’t reported in Ajovy’s clinical studies.

Do not stop taking Ajovy without first talking with your doctor. They may be able to suggest a different treatment to help prevent migraine episodes if you stop taking Ajovy.

Can Ajovy be used to treat a migraine headache?

No, Ajovy is not a treatment for migraine headaches. Ajovy helps prevent migraine headaches before they start.

How is Ajovy different from other migraine drugs?

Ajovy differs from most other migraine drugs because it’s one of the first medications created to help prevent migraine headaches. Ajovy is part of a new class of drugs called calcitonin gene-related peptide (CGRP) antagonists.

Most other medications used to prevent migraine headaches were developed for different purposes, such as treating seizures, depression, or high blood pressure. Many of these drugs are used off-label to help prevent migraine headaches.

Ajovy also differs from most other migraine medications in that it’s injected once a month or once every three months. Most other drugs used to prevent migraine headaches come as tablets that you need to take once each day.

One alternative drug is Botox. Botox is also an injection, but you receive it once every three months in your doctor’s office. You can inject Ajovy yourself at home or have a healthcare professional give you the injection at your doctor’s office.

Also, Ajovy is a monoclonal antibody, which is a kind of drug created from immune system cells. The liver doesn’t break down these drugs, as it does with most other drugs used to prevent migraine headaches. This means that Ajovy and other monoclonal antibodies have fewer drug interactions than other medications that help prevent migraine headaches.

Does Ajovy cure migraine headaches?

No, Ajovy does not help cure migraine headaches. Currently, there are no drugs available that can cure migraine headaches. The migraine drugs that are available can help prevent or treat migraine headaches.

If I take Ajovy, can I stop taking my other preventive medications?

That depends. Everyone’s response to Ajovy is different. If the drug reduces the number of your migraine headaches down to a manageable amount, it’s possible that you may be able to stop using other preventive medications. But when you start taking Ajovy, your doctor will probably prescribe it together with other preventive drugs.

A clinical study found that Ajovy is safe and effective for use with other preventive medications. Other drugs that your doctor may prescribe with Ajovy include topiramate (Topamax), propranolol (Inderal), and certain antidepressants. Ajovy can also be used with onabotulinumtoxinA (Botox).

After you try Ajovy for two to three months, your doctor will probably talk with you to see how well the drug works for you. At that point, the two of you may decide that you should stop taking the other preventive medications, or that you should reduce your dosage for those drugs.

There are other drugs available that can help prevent migraine episodes. Some may be a better fit for you than others. If you’d like to find an alternative to Ajovy, talk with your doctor. They can help you learn about other medications that might be right for you.

Here are some examples of other drugs that the Food and Drug Administration (FDA) has approved to help prevent migraine headaches:

  • the beta-blocker propranolol (Inderal LA, InnoPran XL)
  • the neurotoxin onabotulinumtoxinA (Botox)
  • certain seizure medications, such as divalproex sodium (Depakote) or topiramate (Topamax, Trokendi XR)
  • other calcitonin gene-related peptide (CGRP) antagonists: erenumab-aooe (Aimovig) and galcanezumab-gnlm (Emgality)

Here are some examples of other drugs that may be used off-label for migraine headache prevention:

  • certain seizure medications, such as valproate sodium
  • certain antidepressants, such as amitriptyline or venlafaxine (Effexor XR)
  • certain beta-blockers, such as metoprolol (Lopressor, Toprol XL) or atenolol (Tenormin)

CGRP antagonists

Ajovy is a new type of drug called a calcitonin gene-related peptide (CGRP) antagonist. In 2018, the FDA approved Ajovy to prevent migraine headaches.

There are also other CGRP antagonists available. These include:

How they work

The currently available CGRP antagonists work in slightly different ways to help prevent migraine headaches.

CGRP is a protein in your body. It’s been linked with vasodilation (widening of blood vessels) and inflammation in the brain, which may result in migraine headache pain. To cause these effects in the brain, CGRP needs to bind (attach) to its receptors. Receptors are molecules on the walls of your brain cells.

Ajovy, Emgality, and Vyepti work by attaching to CGRP. This prevents CGRP from attaching to its receptors. Aimovig and Qulipta, on the other hand, work by attaching to the receptors themselves. This keeps CGRP from attaching to them.

By preventing CGRP from attaching to its receptor, these three drugs help prevent vasodilation and inflammation. As a result, they can help prevent migraine headaches.

Side by side

This chart compares some information about Ajovy, Aimovig, Emgality, and Vyepti. These are four injectable CGRP antagonists that are currently approved to help prevent migraine headaches. (To learn more about how Ajovy compares with these drugs, see the “Ajovy vs. other drugs” section below.)

AjovyAimovigEmgalityVyepti
Approval date for migraine headache preventionSeptember 14, 2018May 17, 2018September 27, 2018February 21, 2020
Drug ingredientFremanezumab-vfrm Erenumab-aooe Galcanezumab-gnlm Eptinezumab-jjmr
How it’s administeredSubcutaneous self-injection using a prefilled syringe or autoinjectorSubcutaneous self-injection using a prefilled autoinjectorSubcutaneous self-injection using a prefilled pen or syringeIntravenous (IV) infusion by a healthcare professional
DosingMonthly or every 3 monthsMonthlyMonthlyEvery 3 months
How it worksPrevents CGRP’s effects by binding to CGRP, which prevents it from binding to the CGRP receptorPrevents CGRP’s effects by blocking the CGRP receptor, which prevents CGRP from binding to itPrevents CGRP’s effects by binding to CGRP, which prevents it from binding to the CGRP receptorPrevents CGRP’s effects by binding to CGRP, which prevents it from binding to the CGRP receptor
Cost*$575/month or $1,725/quarter$575/month$575/month$1,500 to $4,500/quarter

*Prices can vary depending on your location, the pharmacy used, your insurance coverage, and manufacturer assistance programs.

Unlike the four drugs described in the table above, Qulipta comes as a tablet. It’s taken by mouth twice a day to prevent migraine headaches. Qulipta was approved by the FDA for this use in September 2021. It’s the first CGRP antagonist medication that’s taken by mouth.

You may wonder how Ajovy compares to other medications that are prescribed for similar uses. Below are comparisons between Ajovy and several medications.

Ajovy vs. Aimovig

Ajovy contains the drug fremanezumab, which is a monoclonal antibody. Aimovig contains erenumab, which is also a monoclonal antibody. Monoclonal antibodies are drugs that have been made from immune system cells. They halt the activity of certain proteins in your body.

Ajovy and Aimovig work in slightly different ways. However, they both halt the activity of a protein called calcitonin gene-related peptide (CGRP). CGRP causes vasodilation (widening of blood vessels) and inflammation in the brain. These effects may result in migraine headaches.

By blocking CGRP, Ajovy and Aimovig help prevent vasodilation and inflammation. This may help prevent migraine headaches.

Uses

Ajovy and Aimovig are both FDA-approved to prevent migraine headaches in adults.

Forms and administration

The drugs Ajovy and Aimovig both come in the form of an injection that’s given as a subcutaneous injection. You can inject the drugs yourself at home. Both drugs can be self- injected into three areas: the front of your thighs, the back of your upper arms, or your belly.

Ajovy comes in the form of a syringe that’s prefilled with a single dose. It’s also available as a prefilled single-dose autoinjector. Ajovy can be given as one injection of 225 mg once a month. As an alternative, it can be given as three injections of 675 mg that are administered quarterly (once every three months).

Aimovig comes as an autoinjector that’s prefilled with a single dose. It’s usually given as a 70-mg injection once a month. But a 140-mg monthly dose may be better for some people.

Side effects and risks

Ajovy and Aimovig work in similar ways and therefore cause some of the same side effects. They also cause some differing side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Ajovy, with Aimovig, or with both drugs (when taken individually).

  • Can occur with Ajovy:
    • no unique common side effects
  • Can occur with Aimovig:
    • constipation
    • muscle cramps or spasms
    • upper respiratory infections such as the common cold or sinus infections
    • flu-like symptoms
    • back pain
  • Can occur with both Ajovy and Aimovig:
    • injection site reactions such as pain, itchiness, or redness

Serious side effects

The primary serious side effect for both Ajovy and Aimovig is a severe allergic reaction. Such a reaction isn’t common, but it is possible. (For more information, see “Allergic reaction” in the “Ajovy side effects” section above).

Aimovig can also cause high blood pressure, including causing high blood pressure in people who didn’t have this condition before. If you already have high blood pressure, taking Aimovig could make it worse.

Immune reaction

In clinical trials for both drugs, a small percentage of people experienced an immune reaction. This reaction caused their bodies to develop antibodies against Ajovy or Aimovig.

Antibodies are proteins in the immune system that attack foreign substances in your body. Your body can create antibodies to any foreign matter. This includes monoclonal antibodies. If your body creates antibodies to Ajovy or Aimovig, the medication may not work for you anymore.

But keep in mind that because Ajovy and Aimovig were approved in 2018, it’s still too early to know how common this effect might be. It’s also too early to know how it might affect how people use these drugs in the future. To date, studies have shown this is rare, though. And these medications appear to be safe for most people.

Effectiveness

These drugs haven’t been directly compared in a clinical trial. However, studies have found both

Ajovy and Aimovig to be effective at preventing both episodic and chronic migraine headaches.

In addition, migraine treatment guidelines recommend either drug as an option for certain people. These include people who have not been able to reduce their monthly migraine days enough with other medications. They also include people who can’t tolerate other medications because of side effects or drug interactions.

Costs

The cost of either Ajovy or Aimovig may vary depending on your treatment plan. To compare prices for these drugs, check out GoodRx.com. The actual price you’ll pay for either of these drugs will depend on your insurance plan, your location, and the pharmacy you use.

Ajovy vs. Emgality

Ajovy contains fremanezumab, which is a monoclonal antibody. Emgality contains galcanezumab, which is also a monoclonal antibody. A monoclonal antibody is a kind of drug created from immune system cells. It halts the activity of certain proteins in your body.

Ajovy and Emgality both stop the activity of calcitonin gene-related peptide (CGRP). CGRP is a protein in your body. It causes vasodilation (widening of blood vessels) and inflammation in the brain, which may result in migraine headaches.

By stopping CGRP from working, Ajovy and Emgality help prevent vasodilation and inflammation in the brain. This may help prevent migraine headaches.

Uses

Ajovy and Emgality are both FDA-approved to prevent migraine headaches in adults.

Emgality is also approved to treat episodic cluster headaches in adults.

Forms and administration

Ajovy comes as a syringe that’s prefilled with a single dose. It’s also available as a prefilled single-dose autoinjector. Emgality comes as a single-dose prefilled syringe or pen.

Both of the drugs are given as a subcutaneous injection. You can self-inject Ajovy and Emgality at home.

Ajovy can be self-injected using one of two different schedules. It can be given as a single injection of 225 mg once per month, or as three separate injections (for a total of 675 mg) once every three months. Your doctor will choose the right schedule for you.

For migraine prevention, Emgality is given as a single injection of 120 mg, once per month. (The very first month’s dose is a two-injection dose totaling 240 mg.)

Both Ajovy and Emgality can be injected into three possible areas: the front of your thighs, the back of your upper arms, or your belly. In addition, Emgality can be injected into your buttocks.

Side effects and risks

Ajovy and Emgality are very similar drugs and cause similar common and serious side effects.

More common side effects

Injection site reactions are the main more common side effect for Ajovy and Emgality. These reactions can include pain, itchiness, and redness. (For more information, see “Injection site reactions” in the “Ajovy side effects” section above).

Serious side effects

A severe allergic reaction is the main serious side effect for Ajovy and Emgality. It’s not common to have such a reaction, but it is possible. (For more information, see “Allergic reaction” in the “Ajovy side effects” section above).

Immune reaction

In separate clinical trials for the drugs Ajovy and Emgality, a small percentage of people experienced an immune reaction. This immune reaction caused their bodies to create antibodies against the drugs.

Antibodies are immune system proteins that attack foreign matter in your body. Your body can create antibodies to any foreign substance. This includes monoclonal antibodies such as Ajovy and Emgality.

If your body creates antibodies to either Ajovy or Emgality, that drug may no longer work for you.

However, it’s still too soon to know how common this effect could be because Ajovy and Emgality were approved in 2018. It’s also too soon to know how it could affect how people use these two medications in the future. To date, studies have shown this is rare, though. And these medications appear to be safe for most people.

Effectiveness

These drugs haven’t been directly compared in a clinical trial. However, studies have found both

Ajovy and Emgality to be effective at preventing both episodic and chronic migraine headaches.

In addition, both Ajovy and Emgality are recommended by treatment guidelines for people who cannot take other medications because of side effects or drug interactions. They’re also recommended for people who can’t reduce their number of monthly migraine headaches enough with other drugs.

Costs

The cost of either Ajovy or Emgality may vary depending on your treatment plan. To compare prices for these drugs, check out GoodRx.com. The actual price you’ll pay for either of these drugs will depend on your insurance plan, your location, and the pharmacy you use.

Ajovy vs. Botox

Ajovy contains fremanezumab, which is a monoclonal antibody. A monoclonal antibody is a kind of drug created from immune system cells. Ajovy helps prevent migraine headaches by halting the activity of certain proteins that trigger migraines.

The main drug ingredient in Botox is onabotulinumtoxinA. This drug is part of a class of drugs known as neurotoxins. Botox works by temporarily paralyzing the muscles into which it’s injected. This effect on the muscles keeps pain signals from being switched on. It’s thought that this action helps prevent migraine headaches before they start.

Uses

The FDA has approved Ajovy to prevent chronic or episodic migraine headaches in adults.

Botox has been approved to prevent chronic migraine headaches in adults. Botox has also been approved to treat many conditions, including:

  • muscle spasticity
  • overactive bladder and urinary incontinence
  • excessive sweating
  • cervical dystonia (painfully twisted neck)
  • eyelid spasms
  • blepharospasm (eyelid twitching)
  • strabismus (misaligned eyes)

Forms and administration

Ajovy comes as a prefilled single-dose syringe, as well as a prefilled single-dose autoinjector. It’s given as a subcutaneous injection that you can give yourself at home. Or, a healthcare professional can give you Ajovy at your doctor’s office.

Ajovy can be given on one of two different schedules: one 225-mg injection once per month, or three separate injections (total of 675 mg) once every three months. Your doctor will choose the right schedule for you.

Ajovy can be injected into three possible areas: the front of your thighs, the back of your upper arms, or your belly.

Botox is given as an intramuscular injection, and it’s always given in a doctor’s office. It’s usually given every 12 weeks when used for preventing migraine.

The sites where Botox is typically injected include on your forehead, above and near your ears, near your hairline at the base of your neck, and on the back of your neck and shoulders. At each visit, your doctor will usually give you 31 small injections into these areas.

Side effects and risks

Ajovy and Botox are both used to prevent migraine headaches, but they work in different ways in the body. Therefore, they have some similar side effects, and some different.

More common side effects

These lists contain examples of serious side effects that can occur with Ajovy, with Botox, or with both drugs (when taken individually).

  • Can occur with Ajovy:
    • few unique common side effects
  • Can occur with Botox:
    • flu-like symptoms
    • headache or worsening migraine headache
    • eyelid droop
    • facial muscle paralysis
    • neck pain
    • muscle stiffness
    • muscle pain and weakness
  • Can occur with both Ajovy and Botox:
    • injection site reactions

Serious side effects

These lists contain examples of serious side effects that can occur with Ajovy, with Botox, or with both drugs (when taken individually).

  • Can occur with Ajovy:
    • few unique serious side effects
  • Can occur with Botox:
    • spread of paralysis to nearby muscles*
    • trouble swallowing and breathing
    • serious infection
  • Can occur with both Ajovy and Botox:
    • serious allergic reactions

* Botox has a boxed warning from the FDA for spread of paralysis to nearby muscles following injection. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Chronic migraine headaches are the only condition that both Ajovy and Botox are used to prevent.

Treatment guidelines recommend Ajovy as a possible option for people who can’t decrease their number of migraine headaches enough with other medications. Ajovy is also recommended for people who aren’t able to tolerate other drugs because of their side effects or drug interactions.

The American Academy of Neurology recommends Botox as a treatment option for people with chronic migraine headaches.

Clinical studies have not directly compared the effectiveness of Ajovy and Botox. But separate studies showed both Ajovy and Botox to be effective in helping prevent chronic migraine headaches.

Costs

The cost of either Ajovy or Botox may vary depending on your treatment plan. To compare prices for these drugs, check out GoodRx.com. The actual price you’ll pay for either of these drugs will depend on your insurance plan, your location, and the pharmacy you use.

The Food and Drug Administration (FDA) approves prescription drugs such as Ajovy to treat or prevent certain conditions.

Ajovy for preventing migraine headaches

The FDA has approved Ajovy to help prevent migraine headaches in adults. These headaches are severe. They’re also the main symptom of migraine, which is a neurological condition.

Sensitivity to light and sound, nausea, vomiting, and trouble speaking are other symptoms that can occur with a migraine headache.

Ajovy is approved to prevent both chronic migraine headaches and episodic migraine headaches. The International Headache Society states that people who have episodic migraine headaches experience fewer than 15 migraine or headache days each month. People who have chronic migraine headaches, on the other hand, experience 15 or more headache days each month over at least 3 months. And at least 8 of these days are migraine days.

Effectiveness for preventing migraine headaches

Ajovy has been found to be effective for preventing migraine headaches. For information on how Ajovy performed in clinical studies, see the drug’s prescribing information.

The American Headache Society recommends the use of Ajovy to prevent migraine headaches in adults who are unable to reduce their number of migraine days enough with other medications. They also recommend Ajovy for people who aren’t able to take other migraine prevention medications because of side effects or drug interactions.

As with all medications, Ajovy injection costs can vary. To find current prices for Ajovy in your area, check out GoodRx.com.


What you find on GoodRx.com is the cost without insurance. The cost with insurance will vary. Your actual cost will depend on your insurance coverage, your location, and the pharmacy you use.

Financial assistance

If you need financial support to pay for Ajovy, help is available. Teva Pharmaceuticals, the manufacturer of Ajovy, has a savings offer that can help you pay less for Ajovy. For more information and to find out if you’re eligible, visit the program website.

Ajovy is a monoclonal antibody. This type of drug is a special immune system protein that’s made in a lab. Ajovy’s mechanism of action (how it works) is by halting the activity of a protein called calcitonin gene-related peptide (CGRP).

CGRP is involved in vasodilation (widening of blood vessels) and inflammation in your brain. CGRP is believed to play a key role in causing migraine headaches. In fact, when people begin to get a migraine headache, they have high levels of CGRP in their bloodstream.

Ajovy helps keep a migraine headache from starting by halting the activity of CGRP.

Most medications target (act on) numerous chemicals or parts of cells in your body. But Ajovy and other monoclonal antibodies only target one substance in the body. As a result, there may be fewer drug interactions and side effects with Ajovy. This may make it a good choice for people who can’t take other drugs because of side effects or drug interactions.

Ajovy may also be a good choice for people who have tried other drugs, but the drugs didn’t do enough to reduce their number of migraine days.

How long does it take to work?

It may take a few weeks for any migraine changes that Ajovy causes to become noticeable. And it may take several months for Ajovy to be fully effective.

The results of clinical studies showed that many people who took Ajovy experienced fewer migraine days within one month of taking their first dose. Over several months, the number of migraine days continued to decrease for people in the study.

How long does it stay in your body?

How long a medication stays in your body depends on the drug’s half-life. This term describes the length of time it takes your body to clear half a dose of a drug. Ajovy’s half-life is 31 days.

The following information describes the usual dosages for Ajovy. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosing schedule for you.

Drug forms and strengths

Ajovy comes as a solution inside single-dose prefilled syringes. It’s also available in single-dose prefilled autoinjectors.

Each syringe or autoinjector contains 225 mg of fremanezumab in 1.5 mL of solution. (Fremanezumab is the active drug in Ajovy.)

Ajovy is given as a subcutaneous injection. You can self-inject the drug at home, or a healthcare professional can give you the injection at your doctor’s office.

Dosage for migraine headache prevention

There are two recommended dosage schedules:

  • one 225-mg subcutaneous injection given every month, or
  • three 225-mg subcutaneous injections given together (one after another) once every three months

You and your doctor will determine the best dosing schedule for you, based on your preferences and lifestyle.

What if I miss a dose?

If you forget or miss a dose, administer the dose as soon as you remember. After that, resume the normal recommended schedule.

For example, if you’re on a monthly schedule, plan the next dose for four weeks after your makeup dose. If you’re on a quarterly schedule, administer the next dose 12 weeks after your makeup dose.

Will I need to use this drug long-term?

If you and your doctor determine that Ajovy is safe and effective for you, you may use the drug long term to prevent migraine headaches.

Ajovy is given as a subcutaneous injection once a month or once every three months. You can administer the injection yourself at home. Or, a healthcare professional can give you the injections at your doctor’s office.

The first time you get a prescription for Ajovy, your healthcare professional can explain how to inject the medication yourself.

Ajovy comes in single-dose, 225-mg prefilled syringes and autoinjectors. Each syringe or autoinjector contains only one dose and is meant to be used once and then discarded.

Below is information on how to use the prefilled syringe. For other information, video, and images of injection instructions, see the manufacturer’s website. You can view instructions for using the autoinjector here.

How to inject

Your doctor will prescribe either 225 mg once per month, or 675 mg once every three months (quarterly). If you’re prescribed 225 mg monthly, you will give yourself one injection. If you’re prescribed 675 mg quarterly, you’ll give yourself three separate injections one after another.

Instructions for injecting Ajovy with prefilled syringes

Below, we describe how to prepare and administer doses of Ajovy.

Preparing to inject Ajovy prefilled syringes

Here’s how to prepare to inject a dose of Ajovy:

  • Thirty minutes before injecting the medication, remove the syringe from the refrigerator. This allows the drug to warm up and come to room temperature. Keep the cap on the syringe until you’re ready to use the syringe. (Ajovy can be stored at room temperature for up to 24 hours. If Ajovy is stored outside of the refrigerator for 24 hours without being used, don’t put it back into the refrigerator. Dispose of it in your sharps container.)
  • Don’t try to warm the syringe up faster by microwaving it or running hot water over it. Also, don’t shake the syringe. Doing these things can make Ajovy less safe and effective.
  • When you take the syringe out of its packaging, be sure to protect it from light.
  • While you wait for the syringe to warm up to room temperature, get gauze or a cotton ball, an alcohol wipe, and your sharps disposal container. Also, make sure you have the correct number of syringes for your prescribed dose.
  • Look at the syringe to make sure the drug isn’t cloudy or expired. The liquid should be clear to slightly yellow. It’s okay if there are bubbles. But if the liquid is discolored or cloudy, or if there are small solid pieces in it, don’t use it. And if there are any cracks or leaks in the syringe, do not use it. If needed, contact your doctor about getting a new one.
  • Use soap and water to wash your hands, and then choose the spot for your injection. You can inject under your skin into these three areas:
    • the front of your thighs (at least two inches above your knee or two inches below your groin)
    • the back of your upper arms
    • your belly (at least two inches away from your belly button)
  • If you want to inject the medication into the back of your arm, someone may need to inject the drug for you.
  • Use the alcohol wipe to clean the injection spot you’ve chosen. Be sure the alcohol is completely dry before you inject the drug.
  • If you’re giving yourself three injections, don’t give yourself any injections in the same spot. And never inject into areas that are bruised, red, scarred, tattooed, or hard to the touch.

Injecting Ajovy prefilled syringes

Here’s how to inject a dose of Ajovy:

  1. Take the needle cap off of the syringe and throw it away in the trash.
  2. Gently pinch at least one inch of skin that you wish to inject.
  3. Insert the needle into the pinched skin at an angle of 45 to 90 degrees.
  4. Once the needle is inserted completely, use your thumb to slowly push the plunger as far as it will go.
  5. After injecting Ajovy, pull the needle straight out of the skin and release the fold of skin. To avoid sticking yourself, don’t recap the needle.
  6. Gently press the cotton ball or gauze onto the injection site for a few seconds. Don’t rub the area.
  7. Throw the used syringe and needle into your sharps disposal container right away.

Timing

Ajovy should be taken once every month or once every three months (quarterly), depending on what your doctor prescribes. It can be taken at any time of the day.

If you miss a dose, take Ajovy as soon as you remember. The next dose should be one month or three months after you take that one, depending on your recommended dosing schedule. A medication reminder tool can help you remember to take Ajovy on schedule.

Taking Ajovy with food

Ajovy can be taken with or without food.

It isn’t known if Ajovy is safe to use during pregnancy. When Ajovy was given to pregnant females in animal studies, no risk was shown to the pregnancy. But the results of animal studies don’t always predict how a drug might affect humans.

If you’re pregnant or thinking about becoming pregnant, talk with your doctor. They can help determine if Ajovy is a good choice for you. You may need to wait to use Ajovy until you’re no longer pregnant.

It’s unknown whether Ajovy passes into human breast milk. Therefore, it’s unclear whether Ajovy is safe to use while breastfeeding.

If you’re thinking about having Ajovy treatment while you’re breastfeeding, talk with your doctor about the possible benefits and risks. If you start taking Ajovy, you may have to stop breastfeeding.

There is no interaction between Ajovy and alcohol.

However, for some people, drinking alcohol while taking Ajovy may seem to make the drug less effective. This is because alcohol is a migraine trigger for many people, and even small amounts of alcohol can cause a migraine headache for them. (Keep in mind that Ajovy is used to help prevent migraine episodes.)

If you find that alcohol causes more painful or more frequent migraine headaches, you should avoid drinks that contain alcohol.

Ajovy hasn’t been shown to interact with other medications. However, it’s still important to talk to your doctor or pharmacist about any prescription medications, vitamins, supplements, and over-the-counter medications you take before starting Ajovy.

Do not use more Ajovy than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Ajovy

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Before taking Ajovy, talk with your doctor about your health history. You should not take Ajovy if you have a history of serious hypersensitivity reactions to Ajovy or any of its ingredients.

A serious hypersensitivity reaction can cause symptoms such as:

  • skin rash
  • itchiness
  • trouble breathing
  • angioedema (swelling under the skin)
  • swelling of the tongue, mouth, and throat

When Ajovy is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the container. This date is typically one year from the date the medication was dispensed.

The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications.

How long a medication remains good can depend on many factors, including how and where the medication is stored.

Ajovy syringes and autoinjectors should be stored in the refrigerator in the original container to protect them from light. They can be safely stored in the refrigerator for up to 24 months, or until the expiration date listed on the container. Once taken out of the refrigerator, each syringe or autoinjector must be used within 24 hours.

If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.