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Two syringes with a "vs." between them: Emgality vs. Aimovig
Drug vs. Drug

Emgality vs. Aimovig: Differences, similarities & side effects

Compare Aimovig versus Emgality to see which is the best migraine treatment for you
Gerardo Sison medical writer headshot
By | Jun. 6, 2024

Key takeaways

  • Emgality and Aimovig, both CGRP antagonists, are used for migraine prevention but differ in active ingredients and dosing requirements.

  • Emgality requires a loading dose and is also approved for episodic cluster headaches, unlike Aimovig.

  • Both medications are generally effective in reducing migraine frequency, with Emgality showing slightly better consistency in being taken as directed.

  • While both drugs have similar side effects, like injection site reactions, Aimovig may also cause constipation and high blood pressure.

In this article:

Emgality and Aimovig are two medications used as preventive treatments for migraine, a condition characterized by intense, debilitating headaches. These medications belong to a class of drugs called calcitonin gene-related peptide (CGRP) antagonists. They work by blocking the CGRP molecule, which is involved in pain and inflammation associated with migraine attacks. 

Both Emgality and Aimovig are brand-name drugs given by injection, typically once a month. As subcutaneous injections, these medications are administered just under the skin of the stomach area, thigh, or upper arm. While they share similarities in how they work and are used, they differ in various ways, including cost and potential side effects. Therefore, it’s important to consult a healthcare provider to determine the most appropriate option. 

Read on to learn more about the similarities and differences between Emgality and Aimovig. 

Emgality vs. Aimovig: Key differences

The main difference between Emgality and Aimovig is in their active ingredients. Emgality, developed by Eli Lilly & Co., contains the active ingredient galcanezumab-gnlm. Aimovig is manufactured by Amgen Inc. and contains the active ingredient erenumab-aooe. Despite their different active components, both drugs target the calcitonin gene-related peptide (CGRP) pathway to prevent migraine headaches.

Regarding administration, both drugs are injected once per month. However, they differ in their dosage forms and delivery devices. Emgality is available as a prefilled pen or syringe. It requires a loading dose of 240 milligrams (mg) before switching to a monthly dose of 120 mg for migraine prevention. A loading dose is an initial higher dose of medication given to quickly achieve a therapeutic level in the bloodstream. 

Aimovig comes as a prefilled autoinjector or syringe. Unlike Emgality, Aimovig does not require a loading dose. Instead, Aimovig can be started as a monthly dose from the first use. The typical dosage is 70 or 140 mg, injected once monthly. 

Emgality vs. Aimovig: Compare key differences
Emgality Aimovig
Drug class CGRP receptor antagonists, monoclonal antibody CGRP receptor antagonists, monoclonal antibody
Brand/generic status Brand Brand
What is the generic name? Galcanezumab-gnlm Erenumab-aooe
What form(s) does the drug come in? Injection under the skin Injection under the skin
What is the standard dosage? Migraine prevention: Two 120 mg injections administered once, followed by 120 mg per month

Episodic cluster headache treatment: Three 100 mg injections administered consecutively, followed by three, 100 mg injections each month until the end of the cluster period

 Migraine prevention: 70 or 140 mg injection once per month
How long is the typical treatment? Long-term Long-term
Who typically uses the medication? Adults Adults

 

Emgality vs. Aimovig: Conditions treated

Emgality and Aimovig are both approved by the Food and Drug Administration (FDA) to prevent migraine in adults. This approval includes the prevention of episodic migraines—defined as fewer than 15 headache days per month—and chronic migraines—defined as 15 or more headache days a month, with at least eight being migrainous.

Emgality has also received FDA approval for the treatment of episodic cluster headaches in adults. People with episodic cluster headaches experience periods of frequent headache attacks, known as “cluster periods,” followed by headache-free intervals. During these cluster periods, individuals may face multiple excruciating headaches per day. Unlike migraines, which often cause throbbing pain on both sides of the head and can be triggered by various factors like light or noise sensitivity, cluster headaches are typically one-sided and have a more intense and debilitating pain intensity.

Neither Emgality nor Aimovig is a cure for migraines or cluster headaches. Rather, they are used to reduce the frequency, severity, and duration of headache episodes. Unlike Emgality, Aimovig has not been approved to treat cluster headaches. 

Emgality vs. Aimovig: Compare conditions treated
Condition Emgality Aimovig
Preventive treatment of migraine Yes Yes
Treatment of episodic cluster headache Yes No

 

Is Aimovig better than Emgality?

Emgality and Aimovig are both effective options for preventing migraines. Clinical studies on Emgality and Eimovig showed they were effective in significantly reducing the number of monthly migraine days (MMDs) compared to a placebo. Specifically, patients receiving these treatments were more likely to achieve at least a 50% reduction in their migraine frequency.

One study compared three different migraine prevention drugs: Emgality (galcanezumab), Ajovy (fremanezumab), and Aimovig (erenumab). It found that people who started with galcanezumab tended to stick with their treatment longer and were less likely to stop using it compared to those on the other two drugs. Specifically, 47.8% of patients on galcanezumab discontinued treatment, which is lower than the 51.7% for fremanezumab and 50.2% for erenumab. The results suggest that galcanezumab might be a more effective option for consistent migraine prevention over time.

Always consult a healthcare provider for medical advice on the most effective treatment option, as effectiveness can vary. 

RELATED: Aimovig alternatives: What can I take instead?

Emgality vs. Aimovig: Insurance coverage and cost 

Many insurance plans cover Emgality and Aimovig, although the extent of coverage can vary based on one’s healthcare provider and the specific insurance plan. Those with Medicare Part D might also find that these medications are covered, but it is recommended to review the plan’s policy details to confirm.

For those without insurance, Emgality and Aimovig may be more expensive than generic options. The cost for a one-month supply of Emgality or Aimovig without insurance may be around $1,000. 

Patients can often reduce their out-of-pocket expenses by using prescription savings programs such as SingleCare. Emgality and Aimovig coupons can provide substantial savings, sometimes lowering costs to a fraction of the retail price.

Compare costs & coverage of Emgality vs. Aimovig
Emgality Aimovig
Typically covered by insurance? Yes Yes
Typically covered by Medicare Part D? Yes Yes
Quantity 1, 1 ml of 120 mg/ml pen 1, 1 ml of 140 mg/ml pen
SingleCare cost $640 $738

 

Aimovig vs. Emgality side effects

Emgality and Aimovig share some common side effects. People who use Emgality or Aimovig may experience injection site reactions, such as pain, redness, and swelling around the area of injection. However, injection site reactions may occur more frequently in people using Emgality. Unlike Emgality, Aimovig may also cause constipation, muscle cramps, and high blood pressure. 

Both drugs can potentially cause serious side effects. For instance, both could trigger an allergic reaction, although this is rare. Symptoms like swelling of the face, severe rash, or difficulty breathing could be signs of a serious allergic reaction requiring immediate medical attention.

Compare side effects of Emgality vs. Aimovig
Emgality Aimovig
Side Effect Applicable? Frequency Applicable? Frequency
Injection site reactions Yes 18% Yes 6%
Constipation No – Yes 1%
High blood pressure No – Yes N/A
Muscle cramps or spasms No – Yes <1%

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.

Source: DailyMed (Emgality), DailyMed (Aimovig)

Emgality and Aimovig drug interactions

Emgality and Aimovig are unlikely to interact with most medications. Neither drug is metabolized or processed in the liver in a way that significantly affects other medications. 

Since both drugs work by influencing the CGRP pathway, the key concern is using them with other CGRP receptor antagonists, which may increase the risk of hypersensitivity or compounded effects. Therefore, these medications should not be used together or with other CGRP receptor antagonists. 

Although these migraine medications do not have extensive drug interactions, it is still important to inform healthcare providers of all medications you take, especially if you have multiple health conditions. 

Emgality and Aimovig drug warnings

Emgality and Aimovig carry warnings on their drug labels for potential hypersensitivity reactions. It’s important to report any signs of allergic reactions, such as hives, swelling, or difficulty breathing, which require immediate medical attention. These reactions may occur within hours or days after taking the medications. 

Aimovig carries additional warnings for serious complications related to constipation and the possibility of new-onset or worsening high blood pressure. It is important to monitor your health closely and seek medical attention if you experience any concerning symptoms. 

It is not known whether Emgality or Aimovig can harm an unborn baby or pass into breast milk. Always consult a healthcare provider before starting a new medication if you are pregnant or breastfeeding.

RELATED: Can you take Aimovig while pregnant?