Fremanezumab (Ajovy) is a drug used to prevent migraine headaches in adults. It’s pronounced free-ma-nez-you-mab.
Your doctor might prescribe it if your migraines are episodic, which means they happen from time to time (up to 14 days a month), or chronic (15 or more a month). They may also suggest this drug if other types of medicines haven’t helped your headaches.
What Is Fremanezumab (Ajovy)?
Fremanezumab is a type of drug called a monoclonal antibody. It’s a liquid that comes already filled in a syringe or a plastic device called an autoinjector. It’s injected just under the skin – that’s called subcutaneously. You might also see this drug called fremanezumab-vfrm.
Is Fremanezumab (Ajovy) Approved by the FDA?
The FDA approved fremanezumab in 2018 for migraine prevention in adults.
Is Ajovy the Only Brand Name for Fremanezumab?
Ajovy is only the brand name under which fremanezumab is sold. There is no generic version available.
How Does Fremanezumab (Ajovy) Work?
People who get migraines have higher amounts of a molecule called CGRP in their bodies. CGRP stands for calcitonin gene-related peptide.
When CGRP is released in your body, it causes intense inflammation in the brain. Scientists think this sets off a series of reactions that are a key cause of migraines.
Fremanezumab targets the CGRP in your brain. There, scientists think it blocks the chain reaction that causes migraine.
How Often Do I Take Fremanezumab (Ajovy)?
You can take fremanezumab in one of two ways: monthly or every 3 months. A health care provider can teach you to inject yourself with the drug, or a friend or family member can learn to give you the shots.
If you’re taking it every month, you’ll get one shot. If you’re taking it every 3 months, you’ll have three shots done one right after the other.
Your doctor can tell you about the pros and cons of each schedule.
How Do I Store Fremanezumab (Ajovy)?
The syringe or autoinjector comes in a cardboard box that protects it from light. Leave it in the box until you’re ready to use it.
Put your fremanezumab in the refrigerator as soon as you have it. But if you can’t get it into the fridge for some reason, it can stay at room temperature (up to 86 degrees) for up to 7 days. If you haven’t used it in that time, throw it away.
Don’t freeze fremanezumab, shake it, or let it sit in the sun. The drug should be colorless. If it’s not clear, looks cloudy, or has flakes in it, don’t use it.
How Do I Take a Shot of Fremanezumab (Ajovy)?
Take fremanezumab out of the refrigerator 30 minutes before you plan to inject it. To take some of the sting out of the injection, let the drug come to room temperature. An injection of cold medication can hurt more than one that is room temperature.
Don’t use a microwave, hot water, or any other method to warm it.
Once you’ve taken it out of the refrigerator, use it within 7 days. Don’t return it to the fridge.
The shots go into your thigh, upper arm, or stomach area. Don’t inject areas where your skin is tender, red, scarred, thick, scaly, or bruised.
Clean the spot (or spots) you plan to inject with rubbing alcohol first. Change up the spots you use to avoid injuring the area. The routine is a little different depending on whether you have the syringe or autoinjector.
You can watch videos at ajovy.com that teach you how to inject fremanezumab with a syringe or an autoinjector.
How Long Does It Take for Fremanezumab (Ajovy) to Work?
It takes 5 to 7 days for the drug to build up to maximum levels in your body. Some people start to have fewer migraines that quickly.
In studies, people who had chronic migraines who took the drug for a year had an average of 5 fewer headache days per month. People with episodic migraines had 3.5 fewer headaches days a month.
Can I Take Fremanezumab (Ajovy) While Pregnant or Breastfeeding?
Researchers don’t have enough information yet to know whether fremanezumab could affect your fetus. They do know it stays in your system a long time.
Scientists also don’t know whether it’s safe for you to take the drug while breastfeeding. You and your doctor should talk about the potential risks of the migraine treatment and the benefits of breastfeeding to decide what’s best for you.
What Are the Side Effects of Fremanezumab (Ajovy)?
The most common side effects of fremanezumab are injection-site reactions. These happen in the part of the body where you inject the drug and can cause:
- Pain
- Swelling
- Red, sore, or warm skin
Some people who use fremanezumab have reactions such as itchy skin, hives, and rashes. This is called hypersensitivity, and it’s usually mild. But some people stop taking the drug because of hypersensitivity. If you react to the drug in this way, your doctor may need to prescribe a steroid for you.
Some side effects can be life-threatening – such as severe anaphylaxis, or allergic reaction – and may occur up to 1 month after you receive your injection. Get medical attention right away if you have:
- Swelling of your face, mouth, tongue, or throat
- Trouble breathing
- Rash
- Itching
- Hives
Less common side effects are constipation and high blood pressure.
How Much Does Fremanezumab (Ajovy) Cost?
The regular price for one Ajovy syringe or autoinjector at a pharmacy starts around $700. If you opt to take Ajovy quarterly, you’ll simply use three syringes or autoinjectors at a time. The price for a 3-month supply is about $2,000.
How much you’ll pay out of pocket for this drug depends on your health insurance plan. Not every insurance plan covers it. Your doctor may have to show that other medicines haven’t worked for you before your insurance will approve it.
If you have a Medicare drug plan, also called Medicare Part D, fremanezumab might be covered, but it depends on your plan. You can get answers about your specific coverage at www.medicare.gov or by calling 800-633-4227.
If you have private insurance, you can get a coupon from the drugmaker that can lower your copay to as little as $5. But you can’t use the coupon if you have any type of government-funded insurance such as Medicare or Medicaid.
If you have a Medicare Part D plan or don’t have health insurance at all, you may be able to get financial assistance from the company that makes the drug.
Can I Take Fremanezumab (Ajovy) With Other Migraine Drugs?
Fremanezumab is designed to prevent migraines, and most people who take it have fewer headaches. But that doesn’t mean you’ll never have a migraine. You might wonder whether it’s safe to take other migraine drugs when you’re using fremanezumab.
In addition to monoclonal antibodies like fremanezumab, a different type of anti-CGRP drug for migraine is available. These drugs, called gepants, are taken by mouth. They include:
- Atogepant (Qulipta)
- Rimegepant (Nurtec)
- Ubrogepant (Ubrelvy)
So far, there’s not much research on whether it’s safe to take gepants at the same time as fremanezumab. In a few small studies, the combination of monoclonal antibodies and gepants worked well, and the side effects were minor.
There’s no one-size-fits-all approach to migraines. Work with your doctor to tailor an individual plan, which might include mixing types of anti-CGRP drugs.
