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Key takeaways
Aimovig is a monthly injectable brand-name drug that targets the peptide CGRP to prevent migraines.
While some patients notice results in the first month, the drug often takes around three months to achieve its potential.
The FDA has specific instructions for how to use Aimovig, and the prescribing healthcare provider should also provide directions.
Migraine attacks can be physically debilitating—sudden, intense, and best endured lying on the couch. And once they start, symptoms can last from hours to days. Aimovig (erenumab-aooe) is one of a few new calcitonin gene-related peptide (CGRP) antagonists, injected monthly, that can actually help prevent migraines before they begin.
Aimovig may start working after the first dose, but for many people, it takes two to three months to see a reduction in monthly migraine days.
How does Aimovig work?
Migraines have a wide range of possible causes, including hormone changes, bright lights, alcohol, stress, and certain odors or foods. With so many causes, it can make people prone to migraines wonder when the next one will strike, how long it will last, and how severe the symptoms will be.
Research has shown that calcitonin gene-related peptide (CGRP) is a common culprit in both chronic and episodic migraines. This chain of amino acids, released from the trigeminal nerve, helps regulate blood pressure and tissue repair. But in the brain, it can cause dilated blood vessels and contribute to migraine headaches.
CGRP inhibitors like Aimovig “work by blocking the absorption of CGRP receptors within neurological cavities; CGRP proteins are inflammatory and believed to be migraine catalysts,” said James Hook, MD, a chiropractor at Neurogan Health. This prevents it from reaching the brain and triggering the nerve.
How long does it take for Aimovig to work?
After the first injection of Aimovig, the drug starts blocking CGRP right away. “Aimovig typically starts to show effectiveness within the first month of treatment, with many patients reporting decreasing frequency of migraine days by the second month,” said Sazan Sylejmani, Pharm.D., a pharmacist in Westmont, Illinois.
However, not everyone sees results immediately. “It may require three months of dosing to kick in, and even after that, the effects of Aimovig take some time to build to full effect,” Dr. Hook said.
A Phase 3 randomized trial of erenumab for episodic migraine looked at the effect of Aimovig on episodic migraine (four to 14 migraine days per month) and on chronic migraine (15 or more headache days per month with at least eight migraine days). About 50% of people taking 140 milligrams (mg) of Aimovig and 40% of people taking 70 mg of Aimovig reduced their episodic migraine days by at least half in the first six months. The results were 40% for both doses of Aimovig in people with chronic migraine. After those initial months, further studies indicated that patients were able to cut their migraine days in half, even after five years of taking Aimovig. It may continue its efficacy after that, but there isn’t research for that far out yet.
The Aimovig dosage you receive might influence how quickly it works. Although patients taking both doses for episodic migraine had a decrease in headaches by one month, patients who took 140 mg saw a more significant decrease in migraine headache days (on average) over the first six months. But not everyone needs a higher dose. Your healthcare provider can provide medical advice on which dosage might work better for you.
“The severity and frequency of migraine episodes, individual metabolic differences, and whether the patient is concurrently using other treatments for migraine will determine which dosage is needed.” Dr. Sylejmani says. “Additionally, lifestyle factors such as diet, stress levels, and sleep patterns can also impact the effectiveness of the medication.”
What to consider before taking Aimovig for migraine
No medication is perfect. Each one comes with considerations—and Aimovig is no exception. That’s why “before beginning treatment, it’s important for patients to discuss their full medical history with their healthcare provider,” Dr. Sylejmani said. “This includes any known allergies, existing medical conditions, and current medications.” Here’s what to think about before starting migraine treatment.
Aimovig side effects
Aimovig may cause certain adverse effects. Not everyone will get them, but they’re still good to know. Possible side effects of Aimovig include:
- Injection site reactions (pain, redness, swelling)
- Constipation
- Muscle cramps or spasms
Around 6% of patients taking 70 mg of Aimovig in clinical trials experienced injection site irritation, while 1% had constipation, and less than 1% got muscle cramps or muscle spasms. For patients taking 140 mg doses, 5% experienced injection site reactions, 3% had constipation, and 2% had cramps or muscle spasms.
In rare cases, Aimovig may cause serious side effects, too, specifically high blood pressure, allergic reactions, and constipation with severe complications. Doctors typically recommend stopping Aimovig in patients who experience severe side effects.
Aimovig warnings
According to the drug’s label, some patients may experience hypersensitivity reactions like rash, angioedema, and even anaphylaxis. These reactions most often occur within hours or days of the injection, and the Food and Drug Administration (FDA) says these patients should discontinue treatment immediately.
Patients who get severe constipation typically notice it after the first dose, and those who get new or worsening hypertension often see it within seven days of a dose. These cases may require separate therapy or even hospitalization, so if you notice either, contact a healthcare professional ASAP.
No studies have evaluated Aimovig’s effects on pregnant women, although the FDA says it had no effect in studies performed on monkeys. Currently, there’s no data on how it might affect breastfeeding, so it’s important for anyone who’s pregnant or planning on getting pregnant to notify their healthcare provider before starting Aimovig.
Drug interactions
Aimovig has no known food or drug interactions. However, it’s still a good practice to let your healthcare provider know if you’re taking other drugs or supplements before taking migraine medication.
Proper use of Aimovig for migraine
Of course, Aimovig can’t prevent migraines unless you administer it correctly. And since it comes as an autoinjector, you’ll perform the injection yourself. Those words might make some people nervous, but it’s a fairly quick and easy process.
Your healthcare provider should walk you through the process so you’ll have step-by-step instructions to follow. But once you get home, it’s all you. First, make sure you store the autoinjector correctly, prep the injection site, administer the injection, and dispose of the syringe according to the usage instructions from the manufacturer, Amgen.
Bottom line
For anyone who’s endured the throbbing, pounding, nauseous discomfort of migraine symptoms, Aimovig could come as a huge relief. Just know that not everyone experiences the benefits right away. While some may see a reduction in migraines after the first monthly injection, many people see the best results around month three.
If you’re concerned about the drug’s efficacy or just want to know your options, ask a healthcare provider about Aimovig alternatives like Ajovy (fremanezumab), Emgality (galcanezumab), topiramate, or Botox. And if you’re looking for ways to save, consider Aimovig coupons that can reduce the average retail price of $1,048.26 per 140 mg dose to $739.35.
RELATED: Emgality vs. Aimovig
Sources
- Role of CGRP signaling in migraine pathophysiology, Amgen
- A Phase 3 randomized trial of erenumab for episodic migraine, Cephalalgia (2018)
- Long-term efficacy and safety of erenumab in migraine prevention: Results from a 5-year, open-label treatment phase of a randomized clinical trial, European Journal of Neurology (2021)
- Patients experience more migraine-free days with Aimovig®, starting at month 1, Amgen (2024)
- Aimovig prescribing information, Food and Drug Administration
- How to take Aimovig, Aimovig.com
