If you use the prescription migraine medication galcanezumab (Emgality), you’d probably like to know more about it. Here are the answers to some of the most common questions people ask about this drug.
What Is Galcanezumab (Emgality) Used For?
Galcanezumab, sometimes called galcanezumab-gnlm, is a medication you take as a shot under your skin. It helps:
- Prevent migraines
- Treat episodic cluster headaches
(Episodic cluster headaches are when you have a series (usually 1-4) of short headaches every day for a period of weeks or months. This is followed by a stretch of time without headaches.)
Before you start galcanezumab, your doctor will teach you or your caregiver how to give the shot. Then you or a caregiver can do the injections on your own.
Galcanezumab comes in three versions:
- 120 milligrams per milliliter in a single-dose prefilled auto-injector pen
- 120 milligrams per milliliter in a single-dose prefilled syringe
- 100 milligrams per milliliter in a single-dose prefilled syringe
The doses are different for migraine and for episodic cluster headaches.
To prevent migraines. Your first dose will be 240 milligrams in two shots of 120 milligrams each, right after each other. Then, you’ll take a monthly shot of 120 milligrams.
For episodic cluster headaches. You’ll take 300 milligrams of galcanezumab in three shots of 100 milligrams each, back-to-back, at the start of your cluster headache period. Continue this monthly until your cluster headache period is done.
How Does Galcanezumab (Emgality) Work?
This medication belongs to a group of drugs called monoclonal antibodies. These are proteins made in a lab that are meant to help your immune system work better. They act like antibodies, which are proteins in your immune system that seek out foreign substances like bacteria or viruses and destroy them.
Galcanezumab blocks a substance in your body that causes migraines called calcitonin gene-related peptide (CGRP).
Experts are still researching how this protein is involved in migraines. But they know that when you have a migraine, your nerves and blood vessels release CGRP. And they know this substance is involved in the pain you feel during a migraine.
How Do You Inject Galcanezumab (Emgality)?
Take your galcanezumab shot around the same day every month. Follow these steps to inject your medication:
Prepare your prefilled syringe or pen. Let the pen or syringe warm up to room temperature for 30 minutes in a place that’s out of direct sunlight. Don’t try to warm it in a microwave or with warm water. Always wash your hands before using it.
Look at the solution before you inject it. Make sure it’s clear, colorless, slightly yellow, or slightly brown. Don’t use it if it’s cloudy or if you see flakes or pieces. Never shake the solution.
Inject the treatment. Do this in a fatty area like your thigh, butt, back of your upper arm, or stomach (but not within 2 inches of your belly button). Avoid any place where your skin is tender, bruised, thick, hard, scaly, or red. Only use each shot once, and use all the solution inside. For your next shot, use a different area of your body.
Throw away the syringe or pens in a puncture-resistant container. Your doctor can give you specifics about how to do this.
Does Galcanezumab (Emgality) Hurt?
The most common side effect of galcanezumab is an injection site reaction. This can include pain, redness, or itchy and irritated skin. In a clinical study, 18% of those taking the drug had such a reaction.
But very few people stop treatment because of this. If it becomes an issue for you, talk to your doctor.
To reduce the chances of such a reaction:
Make sure you get proper instruction. Your doctor or nurse should thoroughly go over how to inject yourself. If there’s anything you’re not sure about, ask them about it.
Use good injection techniques. Be careful to follow your doctor’s instructions for injections. Make sure to let your syringe or pen come to room temperature before you use it, but never heat it.
Choose the right site. Rotate your injection sites each month. To remind yourself of where you injected last time, keep notes on paper or in your phone. Keep in mind that thigh injections may be more painful than those in the belly.
Relax your muscles. Try not to move or stiffen your muscles during your injection. If giving yourself a shot makes you anxious, talk to your doctor. Relaxation techniques like deep breathing help some people.
Use a cold pack or pain relievers. Applying an ice pack to numb the area of your skin before you inject yourself can lower your chances of an injection site reaction. Ask your doctor whether pain relievers you apply to your skin (topical analgesics) might be right for you.
How Long Does It Take for Galcanezumab (Emgality) to Work?
One study found that after 3 months, treatment with galcanezumab reduced the number of migraine days people had each month by almost 5 days.
You might notice changes only a week after you start taking it. But everyone reacts differently to treatment.
What Happens If You Stop Taking Galcanezumab (Emgality)?
Don’t stop taking galcanezumab unless you talk to your doctor first. You won’t have any new side effects if you stop treatment, but your migraine symptoms will come back.
If you take galcanezumab for migraines and miss a dose, take it as soon as possible. Then you can continue to schedule it monthly from the date of this dose.
If you have cluster headaches and miss a dose during a cluster period, take it as soon as you remember. Keep taking it each month from the date of this dose until your cluster period is over.
Can You Take Your Galcanezumab (Emgality) Shot Early?
Never take galcanezumab early or more often than prescribed unless your doctor tells you to.
Follow the directions on your prescription carefully. If you don’t understand something, ask your doctor. Never use more or less galcanezumab than prescribed.
Does Galcanezumab (Emgality) Cause Hair Loss?
One study found a link between hair loss and galcanezumab, as well as a few other similar migraine drugs.
Experts found that in clinical trials, some hair loss was reported in 1% of people on galcanezumab. But most cases were mild or moderate. No one in the study stopped the medication because of this side effect.
How Much Does Galcanezumab (Emgality) Cost?
How much you pay for galcanezumab depends on whether you have insurance and what type. The list price is about $679 for a 120-milligram prefilled pen or syringe, but most people won’t pay that much.
Your insurance provider can give you more specifics. But on average, here’s what you might expect:
If you have private insurance. Your cost will depend on whether you’ve met your deductible for the year. For most with private insurance, prescriptions cost between $0 and $25 a month.
You may be eligible for an Emgality Savings Card, which can help you get the treatment at no or low cost for up to a year. Ask your doctor about this program.
If you have Medicare Part D (drug) coverage. For most people, out-of-pocket costs vary throughout the year depending on what phase of coverage you’re in. You can generally expect to pay anywhere from $0 to $150 each month.
If you qualify for Medicare’s Extra Help program, you might pay $4-$9 for each prescription.
If you have Medicaid coverage. People with Medicaid will likely pay $4-$9 each month.
If you don’t have insurance or if your insurance doesn’t cover galcanezumab. In this situation, you’ll probably have to pay around the list price for galcanezumab (Emgality) as well as any charges your pharmacy adds.
The nonprofit Lilly Cares Foundation can help people who meet the financial requirements get the medication at no cost.
There are no generic versions of this drug.
