Emgality is a brand-name prescription medication that’s used to prevent migraines in adults. It comes as a prefilled pen or syringe that you use to give yourself a monthly injection.

Emgality contains the drug galcanezumab, which is a monoclonal antibody. A monoclonal antibody is a type of drug developed from immune system cells in a lab. It blocks the activity of certain proteins in your body.

Emgality can be used to prevent both chronic and episodic migraines. According to the International Headache Society, people with chronic migraines have 15 or more migraine days per month. People with episodic migraines have fewer than 15 migraine days per month.

In clinical studies of people with chronic migraines, 28 percent of people who took Emgality for 3 months cut in half their number of migraine days per month. In clinical studies of people with episodic migraines, about 60 percent of people who took Emgality for 6 months cut in half their number of migraine days per month.

Emgality may be an especially effective option for people who’ve been unable to reduce their number of migraine days enough with other therapies. It may also be a good option for people who can’t take other medications to prevent migraines because of drug interactions or difficult side effects.

A new kind of drug

Emgality belongs to a new class of drugs called calcitonin gene-related peptide (CGRP) antagonists. CGRP antagonists were designed specifically to prevent migraines.

Emgality, which was approved in September 2018, was the third drug in this class approved by the Food and Drug Administration (FDA). The other FDA-approved CGRP antagonists are Aimovig, which was approved in May 2018, and Ajovy, which was approved in September 2018.

A fourth CGRP antagonist, called eptinezumab, is currently being studied and is expected to be approved soon.

Emgality contains the drug galcanezumab. It only comes as a brand-name medication.

Emgality isn’t available in a generic form at this time.

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

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

More common side effects

The most common side effects of Emgality are injection site reactions. This can include the following effects at the site where you inject the drug:

  • redness
  • itchiness
  • pain
  • tenderness

Injection site reactions are usually not severe or lasting. Most of the side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Serious side effects from Emgality aren’t common, but they can occur. The primary serious side effect is a severe allergic reaction to Emgality. See below for details.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Emgality. Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

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

Call your doctor right away if you have a severe allergic reaction to Emgality. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Fatigue

Fatigue (low energy) was not reported as a side effect in clinical studies of Emgality.

However, fatigue is commonly a symptom of migraines that people can experience before, during, or after a migraine. One of people with migraines found that those with more intense headaches were more likely to feel fatigue.

If fatigue is having a negative impact on your life, talk with your doctor about ways to improve your energy levels.

Long-term side effects

Emgality is a recently approved medication in a new class of drugs. As a result, there’s very little long-term research on Emgality’s safety. The longest of Emgality lasted one year, and people in the study did not report any serious side effects caused by Emgality.

Injection site reaction was the most common side effect reported in the year-long study. Other side effects reported included:

As for all medications, prices for Emgality can vary. To find current prices for Emgality in your area, check out GoodRx.com.

The cost shown on GoodRx.com is what you may pay without insurance. Your actual cost will depend on your insurance coverage and the pharmacy you use.

Financial assistance

If you need financial support to pay for Emgality, help is available.

Eli Lilly and Company, the manufacturer of Emgality, offers a savings card that can help you pay less for Emgality. For more information and to find out if you’re eligible, call 833-364-2548 or visit the program website.

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

Emgality for migraines

Emgality is FDA-approved to prevent migraines in adults. It’s used to prevent both episodic and chronic migraines. Chronic migraines occur on 15 or more days per month, while episodic migraines occur on fewer than 15 days per month.

Uses that are not approved

Doctors may also prescribe drugs for other conditions that are not FDA-approved. This use is called off-label drug use.

Emgality for cluster headaches

Emgality is not FDA-approved to prevent cluster headaches, but it may be used off-label for this purpose.

Cluster headaches are painful headaches that happen in clusters (several headaches in a short time period). This type of headache is very painful and can be episodic or chronic. Episodic cluster headaches have longer headache-free periods in between clusters than chronic cluster headaches do.

In one clinical study, Emgality reduced the number of weekly headache attacks in people with episodic cluster headaches over three weeks of treatment. The number of weekly cluster headaches was reduced by half or more for 76 percent of people who received the drug.

However, in this study, people received 300 mg of Emgality per month, which is higher than the FDA-approved dosage. And a similar study that also used the 300-mg dose found that Emgality did not prevent chronic cluster headaches over 12 weeks of treatment.

Additional clinical studies testing whether Emgality can prevent cluster headaches are ongoing.

Emgality for vestibular migraines

Emgality is not FDA-approved to treat or prevent vestibular migraines. Vestibular migraines are different from classic migraines in that they’re not painful most of the time. Instead, people with vestibular migraines will commonly feel vertigo or dizziness that lasts from seconds to hours.

It’s not known at this time if Emgality is effective at preventing or treating vestibular migraines. The drug is not being tested in clinical studies of people with vestibular migraines, but doctors may still choose to prescribe it off-label for this condition.

Other drugs are available that can help prevent migraines. Some may be better suited for you than others. If you’re interested in finding an alternative to Emgality, talk to your doctor to learn more about other medications that may work well for you.

Examples of other drugs that are FDA-approved for migraine prevention include:

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

Examples of other drugs that may be used off-label to prevent migraines include:

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

CGRP antagonists

Emgality is a calcitonin gene-related peptide (CGRP) antagonist, which is a new type of drug. Emgality was approved by the FDA to prevent migraines in 2018, as were two other CGRP antagonists: Aimovig and Ajovy. A fourth (eptinezumab) is expected to be approved soon.

How they work

The three available CGRP antagonists work in slightly different ways to prevent migraines.

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

Emgality and Ajovy work by binding to the CGRP, which prevents the CGRP from binding to its receptors. Aimovig, on the other hand, works by binding to the receptors themselves, which blocks the CGRP from doing the same.

By blocking CGRP from binding with its receptor, all three drugs help prevent inflammation and vasodilation, which can help prevent migraines.

Side by side

The chart below compares general information about the three CGRP antagonists that are currently approved to prevent migraines. For more information on how Emgality compares with these drugs, see the following section (“Emgality vs other drugs”).

AimovigAjovyEmgality
Approval date for migraine preventionMay 17, 2018September 14, 2018September 27, 2018
Drug ingredientErenumab-aooeFremanezumab-vfrmGalcanezumab-gnlm
How it’s administeredSubcutaneous self-injection using a prefilled autoinjectorSubcutaneous self-injection using a prefilled syringeSubcutaneous self-injection using a prefilled pen or syringe
DosingMonthlyMonthly or every three monthsMonthly
How it worksPrevents 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$575/month or $1,725/quarter$575/month

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

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

Emgality vs. Aimovig

Emgality contains a monoclonal antibody called galcanezumab. Aimovig also contains a monoclonal antibody, which is called erenumab. A monoclonal antibody is a type of drug developed from immune system cells in a lab. It blocks the activity of certain proteins in your body.

While they do it in slightly different ways, Emgality and Aimovig both block the activity of a protein called calcitonin gene-related peptide (CGRP). CGRP causes inflammation and vasodilation (widening of blood vessels) in the brain, which may cause migraines. By blocking CGRP, these drugs help prevent these effects, which may help prevent migraines.

Uses

Emgality and Aimovig are both FDA-approved to prevent migraines in adults.

Forms and administration

Emgality and Aimovig both come as an injection that’s given under your skin (subcutaneous) that you administer yourself at home.

Emgality comes as a single-dose prefilled syringe and a single-dose prefilled pen. Both forms give a 120-mg injection.

Aimovig comes as a single-dose prefilled autoinjector. It gives a 70-mg injection. However, some people may benefit from a 140-mg monthly dose of Aimovig. (Your doctor will decide the best dose for you.)

After the first dose, which includes two injections, Emgality is injected once per month. Aimovig is injected monthly. Both drugs can be injected in your abdomen (belly), front of your thighs, or back of your upper arms. Emgality can also be injected in your buttocks.

Side effects and risks

Emgality and Aimovig both belong to the class of drugs called CGRP antagonists. They’re very similar drugs and cause similar common and serious side effects.

More common and serious side effects

Below are examples of these side effects.

Emgality and AimovigEmgalityAimovig
More common side effects• injection site reactions

• back pain

• respiratory tract infection

• sore throat

• sinus infection

• constipation

• muscle cramps

• muscles spasms

Serious side effects• serious allergic reactions

(few unique serious side effects)(few unique serious side effects)

Immune reaction

In clinical trials of both Emgality and Aimovig, a small percentage of people had an immune reaction in which they developed antibodies against the drugs.

Antibodies are proteins in the immune system that fight foreign substances in your body as invaders. The body can make antibodies to any foreign substance, including monoclonal antibodies. If this happens with Emgality or Aimovig, the drug may no longer work for you.

In clinical studies of Emgality that lasted up to 6 months, 4.8 percent of people taking 120 mg per month of the drug developed antibodies to the drug.

In clinical studies of Aimovig that lasted 6 months, more than 6 percent of people taking 70 mg per month developed antibodies to the drug. And nearly 3 percent of people taking 140 mg per month of Aimovig developed antibodies.

However, because this drug was approved in 2018, it’s still too early to know how common this effect will be and how it might affect how people use these drugs.

Effectiveness

Emgality and Aimovig are both FDA-approved to prevent migraines, but they have not been directly compared in clinical studies. They’re both new medications, so they’re not yet included in treatment guidelines. However, they’re both effective for preventing migraines.

Episodic migraines

In clinical studies of Emgality, around 60 percent of people with episodic migraines who took the drug cut their number of migraine days at least in half over 6 months. Up to 16 percent were migraine-free over 6 months of treatment.

In clinical studies of Aimovig, about 40 percent of people with episodic migraines who received 70 mg of the drug cut their migraine days in half over 6 months of treatment. About 50 percent of people who received 140 mg saw similar results.

Chronic migraines

In clinical studies of Emgality, almost 30 percent of people with chronic migraines who took the drug for 3 months had half as many migraine days after treatment.

In a 3-month clinical study of Aimovig, about 40 percent of people with chronic migraines who received either 70 mg or 140 mg of the drug had half as many migraine days after treatment.

Costs

Emgality and Aimovig are both brand-name medications. There are currently no generic forms of either drug. Brand-name drugs usually cost more than generics.

While the manufacturer’s price is the same for both drugs, estimates from GoodRx.com indicate that Emgality may cost slightly more than Aimovig. The actual price you’ll pay for either drug will depend on your insurance plan, the pharmacy you use, and the dosage you’re taking.

Emgality vs. Ajovy

Emgality contains a monoclonal antibody called galcanezumab. Ajovy contains a monoclonal antibody called fremanezumab. A monoclonal antibody is a type of drug developed from immune system cells in a lab. It blocks the activity of certain proteins in your body.

Emgality and Ajovy both block the activity of a protein in your body called calcitonin gene-related peptide (CGRP). CGRP causes inflammation and vasodilation (widening of blood vessels) in the brain, which may cause migraines. By blocking CGRP, these drugs help prevent these effects, which may help prevent migraines.

Uses

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

Forms and administration

Emgality comes as a single-dose prefilled syringe or pen. Ajovy comes as a single-dose prefilled syringe.

Both drugs are given as an injection under the skin (subcutaneous) that you administer yourself at home. Emgality is given as a single injection of 120 mg, once per month. (The first month is a 2-injection dose totaling 240 mg).

Ajovy can be self-injected in two different schedules. It can be given as a single injection of 225 mg once per month, or as 3 separate injections (for a total of 675 mg) every 3 months. Your doctor will choose the right schedule for you.

Both drugs can be injected in your belly, front of your thighs, or back of your upper arms. Emgality can also be injected in your buttocks.

Side effects and risks

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

More common side effects

More common side effects that can occur with both Emgality and Ajovy include injection site reactions. These reactions can cause symptoms such as redness, itchiness, and pain at the spot where you injected the medication. Injection site reactions are usually not severe.

People who took Emgality in clinical studies also reported:

Serious side effects

Serious side effects that can happen with both Emgality and Ajovy are not common, but they’re possible. Call your doctor right away if you’re concerned about your side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Emgality and Ajovy can both cause serious allergic reactions. These reactions are rare but can be severe. Symptoms of a serious allergic reaction include:

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

Immune reaction

In clinical trials for Emgality and Ajovy, a small percentage of people had an immune reaction in which their body developed antibodies against the drugs.

Antibodies are proteins in your immune system that fight foreign substances in your body as invaders. The body can make antibodies to any foreign substance, including monoclonal antibodies such as Emgality and Ajovy.

If your body develops antibodies to one of these drugs, it’s possible that the drug will no longer work for you.

In clinical studies that lasted up to 6 months, 4.8 percent of people taking 120 mg per month of Emgality developed antibodies to the drug. In clinical studies of Ajovy, less than 2 percent of people taking monthly or quarterly doses of Ajovy developed antibodies to the drug over 6 months.

However, as this drug was approved in 2018, it’s still too early to know how common this effect will be and how it might affect how people use these drugs.

Effectiveness

Emgality and Ajovy are both FDA-approved to prevent migraines, but they have not been directly compared in clinical studies. They’re both new medications, so they’re not yet included in treatment guidelines. However, they’re both effective for preventing migraines.

Episodic migraines

In a 6-month clinical study of Emgality, around 60 percent of people with episodic migraines reduced their number of migraine days by at least half with treatment. Up to 16 percent were migraine-free over 6 months of treatment.

In clinical studies of Ajovy, around 48 percent of people with episodic migraines who received monthly Ajovy treatment cut their migraine days in half over three months of treatment. About 44 percent of people who received Ajovy every 3 months had similar results.

Chronic migraines

In clinical studies of people with chronic migraines, almost 30 percent of people who took Emgality for 3 months had half as many migraine days with treatment.

In a 3-month clinical study of Ajovy, nearly 41 percent of people with chronic migraines who received monthly Ajovy had half as many migraine days after treatment. Around 37 percent of people who received Ajovy every 3 months had similar results.

Costs

Emgality and Ajovy are both brand-name medications. There are no generic forms of either drugs available at this time. Brand-name medications generally cost more than generics.

While the manufacturer's price is the same for both drugs, estimates from GoodRx.com indicate that Emgality may cost more than Ajovy. The actual amount you’ll pay for either drug will depend on your insurance plan and the pharmacy you use.

Emgality vs. Botox

Emgality contains a monoclonal antibody called galcanezumab. A monoclonal antibody is a type of drug developed from immune system cells in a lab. Emgality works to prevent migraines by blocking the activity of certain proteins that cause migraines.

Botox contains the drug onabotulinumtoxinA. It belongs to a class of drugs called neurotoxins. Botox temporarily paralyzes the muscles into which it’s injected. By paralyzing these muscles, Botox prevents pain signals from being activated. This is thought to prevent migraines before they start.

Uses

Emgality is FDA-approved to prevent chronic and episodic migraines in adults.

Botox is approved to prevent chronic migraines (15 or more migraine days per month) in adults. Botox is also approved to treat several conditions, including:

Forms and administration

Emgality comes as a single-dose prefilled syringe or pen. After the first dose, which includes 2 injections, it’s given as a single injection of 120 mg once per month. Emgality is injected under the skin (subcutaneous), and you give yourself the injection at home.

Emgality may be injected in your belly, the front of your thighs, the back of your upper arms, or your buttocks.

Botox is always given in a doctor’s office. It’s given as an injection into a muscle (intramuscular), typically every 12 weeks.

The usual sites for injection include your forehead, the back of your neck and shoulders, above and near your ears, and near your hairline at the base of your neck. For each appointment, your healthcare provider will typically give you 31 small injections across these areas.

Side effects and risks

Emgality and Botox are both used to prevent migraines, but they work in different ways in the body. Therefore, they have some of the same side effects, and some different.

Emgality and BotoxEmgalityBotox
More common side effects• injection site reactions

sore throat

back pain

• respiratory tract infection

sinus infection

• flu-like symptoms

• headache or worsening migraine

• eyelid droop

• facial muscle paralysis

• neck pain

• muscle stiffness

• muscle pain and weakness

Serious side effects• serious allergic reactions

(few unique serious side effects)• spread of paralysis to nearby muscles*

• trouble swallowing and breathing

• serious infection

*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

The only condition both Emgality and Botox are used to prevent is migraines. Botox is only used to prevent chronic migraines, while Emgality is used to prevent both episodic and chronic migraines.

The effectiveness of these drugs hasn’t been directly compared in clinical studies. However, both are effective at preventing chronic migraines.

In clinical studies of people with chronic migraines over 24 weeks, Botox reduced the number of migraine days by up to 9.2 days on average per month. In , around 47 percent of people decreased their number of migraine days by about half with Botox treatment.

In clinical studies of people with chronic migraines over 3 months, almost 30 percent of people who took Emgality had half as many migraine days.

Emgality is newly approved and is not yet included in treatment guidelines. Botox, which was approved in 2010, is recommended as a treatment option for people with chronic migraines by the American Academy of Neurology.

Costs

Emgality and Botox are both brand-name medications. There are no generic forms of either drug at this time.

According to estimates on GoodRx.com, Botox is typically less expensive than Emgality. However, the actual price you pay will depend on your insurance plan and the pharmacy you use.

Emgality vs. Topamax

Emgality contains the monoclonal antibody galcanezumab. A monoclonal antibody is a type of drug developed from immune system cells in a lab. Emgality works to prevent migraines by blocking the activity of certain proteins that cause migraines.

Topamax contains the drug topiramate, a type of anti-epileptic drug. How it works in preventing migraines is not well understood. It’s believed to decrease overactive nerve cells in the brain that may cause migraines.

Uses

Both Emgality and Topamax are FDA-approved to prevent migraines. Emgality is approved for this use in adults, while Topamax is approved to prevent migraines in adults and children aged 12 and older.

Topamax is also approved to treat epilepsy.

Forms and administration

Emgality comes as a single-dose prefilled syringe or pen. After the first dose, which includes 2 injections, it’s given as a single injection of 120 mg once per month. Emgality is injected under the skin (subcutaneous), and you give yourself the injection at home.

Topamax comes as a capsule or tablet. The usual dosage is 50 mg twice daily. However, your doctor will start you on a lower dose and increase to the usual dosage over several weeks.

Side effects and risks

Emgality and Topamax work in different ways in the body and therefore have different side effects. Some of the common and serious side effects of both drugs are listed below. This list does not include all possible side effects.

Emgality and TopamaxEmgalityTopamax
More common side effects• respiratory tract infection

sore throat

sinus infection

• injection site reactions

• back pain

• fatigue

paresthesia (feeling of “pins and needles”)

nausea

diarrhea

• weight loss

• loss of appetite

• trouble concentrating

Serious side effects• serious allergic reactions

(few unique serious side effects)• vision problems, including glaucoma

decreased sweating (inability to regulate body temperature)

metabolic acidosis

• mental effects such as confusion, memory problems, and depression

• suicidal thoughts and actions

dependence on the drug

encephalopathy (brain disease)

kidney stones

Effectiveness

The only purpose both Emgality and Topamax are used for is migraine prevention. The effectiveness of these drugs in preventing migraines hasn’t been directly compared in clinical studies. However, both drugs are effective at preventing migraines.

Episodic migraines

In clinical studies of people with episodic migraines over 26 weeks, people ages 12 years and older who took Topamax had about 2 fewer migraines per month. In a clinical study in children, participants aged 12 through 17 had 3 fewer migraines per month when taking the drug over 16 weeks.

In a 6-month clinical study of people with episodic migraines, around 60 percent of people cut their number of migraine days at least in half over 6 months of Emgality treatment. Up to 16 percent were migraine-free after 6 months of treatment.

Topiramate is recommended in treatment guidelines as an option for people with episodic migraines. Emgality is a newly-approved drug and has not yet been included in current guidelines.

Chronic migraines

that pooled the results of several clinical trials found that Topamax reduced the number of migraines or other headaches by about five to nine per month, in people with chronic migraines.

In clinical studies of Emgality, almost 30 percent of people with chronic migraines had half as many migraine days with 3 months of treatment.

Costs

Emgality and Topamax are both brand-name medications. Emgality is not available in a generic form. Topamax does have a generic form, which is called topiramate.

Brand-name medications usually cost more than generic medications. According to estimates on GoodRx.com, Emgality and Topamax may cost around the same amount, depending on your dose. However, the generic form of Topamax costs less than Emgality or Topamax.

Whichever drug or form you use, the actual price you pay will depend on your insurance plan and the pharmacy you use.

The following information describes the dosage that’s commonly used or recommended. However, be sure to follow your doctor’s instructions.

Drug forms and strengths

Emgality comes in two forms: a single-dose prefilled syringe and a single-dose prefilled pen. Both forms contain 120 mg of galcanezumab per milliliter of solution. Each syringe and pen is made to be used once and then discarded.

Dosage for migraine prevention

Each prefilled syringe and prefilled pen contains one 120-mg dose of Emgality. The typical dosage for Emgality is:

  • First dose: Your first dose is called a loading dose. It will be 2 injections of 120 mg, given one after the other. Injecting two doses allows the drug to quickly reach an effective level in your body.
  • All other doses: The second dose is given one month after the first. From the second dose on, you will take a single injection of 120 mg once per month.

What if I miss a dose?

Take a dose as soon as you realize that you missed one. Your next dose should be a month after that one. Remember the new date so you can plan future doses accordingly.

Will I need to use this drug long-term?

If Emgality is effective at preventing migraines for you, you and your doctor may decide to continue treatment with Emgality long-term.

There is no interaction between Emgality and alcohol.

However, for some people, drinking alcohol while taking Emgality 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 for them.

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

Many drugs can interact with other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

However, Emgality doesn’t generally have drug interactions. This is because of the way Emgality is processed in the body.

Many drugs, herbs, and supplements are metabolized (broken down) by enzymes in the liver. Monoclonal antibodies such as Emgality, on the other hand, are not generally metabolized in the liver. Instead, they’re broken down inside cells throughout the body.

Because Emgality isn’t broken down in the liver with other drugs, it generally doesn’t interact with them. But if you’re concerned about taking Emgality with other medications you may be using, talk to your doctor.

Emgality is taken as an injection under your skin (subcutaneous) once each month. When you first get your prescription for Emgality, your healthcare provider will explain how to inject the medication yourself.

The first time you inject Emgality, you may do it at your doctor’s office or at your home. Either way, you’ll give yourself two separate injections. After that, you’ll give yourself one injection at home each month.

Emgality comes in two forms: a single-dose prefilled syringe and a single-dose prefilled pen. Both forms contain only one dose and are meant to be used once and then discarded. Your doctor will discuss with you whether the pen or syringe is right for you.

Below is information on how to use both the syringe and the pen. For other information, video, and images of injection instructions, see the manufacturer’s website.

Note: Remember that for your very first dose, you’ll need two syringes or pens.

How to inject

The instructions for using the Emgality pen and syringe are slightly different. However, the preparation for both is the same.

Preparing to inject

  • Take the pen or syringe out of the refrigerator 30 minutes before injecting. This allows the medication to come to room temperature. Leave the cap on until you’re ready to use the device. (Once you take the pen or syringe out of the refrigerator and it reaches room temperature, do not put it back into the refrigerator.)
  • Don’t try to warm up the pen or syringe faster by microwaving it or running hot water over it. Also, don’t shake the pen or syringe. Doing these things can make Emgality less safe and effective.
  • While you wait for Emgality to come to room temperature, gather an alcohol wipe, cotton ball or gauze, and your sharps disposal container.
  • When you take the pen or syringe out of its packaging, be sure to protect it from light.
  • Check the pen or syringe to make sure the medication is not cloudy or expired. It should be clear to slightly yellow or brown. Bubbles are okay. But if it’s discolored, cloudy, or has small solid pieces in the liquid, do not use it. Contact your doctor about getting a new one, if needed.
  • Wash your hands with soap and water and choose your injection site. Emgality can be injected in the following places:
    • your belly (at least two inches away from your belly button)
    • 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 buttocks
  • If you choose to inject in your arms or buttocks, you may need someone to give you the injection.
  • Clean the area you choose with the alcohol wipe. Allow the alcohol to completely dry before you inject Emgality.
  • The first time you use Emgality, you will need two injections. Don’t give yourself both injections in the same spot. And never inject into areas that are bruised, red, or hard to the touch.

Using the Emgality prefilled pen

  1. Take the cap off the pen and throw it away in the trash.
  2. Place the base of the pen flat and firmly against the injection area.
  3. Turn the lock ring on the top of the pen to the unlock position. (You’ll see lock and unlock symbols on the pen.)
  4. Press and hold the teal injection button (on the top of the pen) until you hear a loud click.
  5. Hold the pen in place for about 10 seconds, until you hear a second click. The second click means that all of the medication has been injected under your skin.
  6. Take the pen away from the skin and dispose of it in your sharps container.
  7. If you bleed at the injection site, place a cotton ball or gauze against your skin. Don’t rub the injection site.

Using the Emgality prefilled syringe

  1. Take the cap off the syringe and throw it away in the trash.
  2. Gently pinch the area of skin you’re using for the injection site. Hold a fold of the skin between your fingers.
  3. Insert the needle into the fold of skin at a 45-degree angle.
  4. Use your thumb to slowly push on the thumb pad at the top of the syringe. Push the thumb pad until you see the gray plunger inside the syringe reach the needle end of the syringe.
  5. Remove the needle from your skin and gently release the fold of skin.
  6. Place the syringe into your sharps disposal container.
  7. If you bleed at the injection site, place a cotton ball or gauze against your skin. Don’t rub the injection site.

Timing

Emgality should be taken once every month. It can be taken at any time of day.

If you miss a dose, take Emgality as soon as you remember. The next dose should be taken one month after you take that one. A medication reminder tool can help you remember to take Emgality on schedule.

Taking Emgality with food

Emgality can be taken with or without food.

Emgality is a monoclonal antibody, which is a special immune system protein created in a lab. Emgality works by blocking the activity of the calcitonin gene-related peptide (CGRP) protein in your body. CGRP is involved in inflammation and vasodilation (widening of blood vessels) in your brain.

CGRP is thought to play an important role in causing migraines. In fact, people who are starting to get a migraine have high levels of CGRP in their blood. By blocking the activity of CGRP, Emgality helps prevent a migraine from starting.

While most drugs target (act on) multiple chemicals or parts of cells in your body, monoclonal antibodies such as Emgality only target one substance in the body. As a result, Emgality has fewer side effects and drug interactions. This may make it a good option for people who can’t tolerate other medications.

It may also be a good option for people who have tried other medications that didn’t help reduce their migraine days enough.

How long does it take to work?

It may take a few weeks for you to notice any migraine changes caused by Emgality. And it may take several months for Emgality to take full effect.

In clinical studies, many people who took Emgality had fewer migraine days within one month of their first dose. The number of migraine days continued to decrease over several months.

There aren’t enough studies to know if Emgality is safe to take during pregnancy. Animal studies showed no harm to a pregnancy when the mother received Emgality. However, animal studies do not always predict whether drugs will be safe in humans.

If you’re pregnant or considering becoming pregnant, talk with your doctor to see if Emgality is right for you. You may need to wait until you’re no longer pregnant to use Emgality.

It’s not known if Emgality passes into breast milk.

If you’re breastfeeding your child or would like to, your doctor will talk with you about the risks and benefits of breastfeeding while taking Emgality. You may need to stop breastfeeding if you begin taking Emgality.

Here are answers to some frequently asked questions about Emgality.

Is Emgality a triptan?

No, Emgality is not a triptan. Triptans, such as sumatriptan (Imitrex), are a class of medications that are used to treat migraines when they occur. Emgality is used to prevent migraines from happening. Emgality and triptans work in different ways to affect migraines.

Is Emgality the same as Aimovig?

No. Emgality (galcanezumab) and Aimovig (erenumab) are both medications used to prevent migraines, and they both belong to a new class of drugs called calcitonin gene-related peptide (CGRP) antagonists. However, they work in slightly different ways.

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

Emgality works by binding to the receptors itself, which blocks CGRP from doing the same. Aimovig, on the other hand, binds to CGRP, which also prevents CGRP from binding to the receptors.

So both drugs block CGRP from binding to its receptors, but they do it in slightly different ways. Your doctor will determine which medication is right for you.

How is Emgality different from other migraine drugs?

Emgality is different from most other migraine drugs because it’s one of the first drugs developed specifically to prevent migraines. It belongs to a new class of drugs called calcitonin gene-related peptide (CGRP) antagonists.

Most other drugs used to prevent migraines were initially developed for different purposes, such as treating depression, seizures, or high blood pressure. Many are used off-label to prevent migraines.

Emgality is also different from most other migraine drugs because it’s injected once per month. Most other medications used to prevent migraines are tablets or pills that need to be taken daily. Botox, one alternative drug, is an injection, but it’s given once every three months in a doctor’s office. Emgality is given as a self-injection in your home.

In addition, Emgality is a monoclonal antibody. This is a type of drug developed from immune system cells in a lab. These drugs are not broken down by the liver, as most other migraine prevention drugs are. As a result, Emgality and other monoclonal antibodies have fewer drug interactions than other drugs that prevent migraines.

Does Emgality cure migraines?

No, Emgality does not cure migraines. There are no medications available at this time that can cure migraines.

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

Every person’s response to Emgality will be unique. Some may be able to stop taking their other preventive medications, while others may not. For instance, if you have more frequent migraines, Emgality may be best used as an addition to the medications you already take.

Injecting multiple doses of Emgality can increase your risk of injection site reactions. If you’re hypersensitive or allergic to Emgality, you may also be at risk of having a more severe reaction.

Symptoms of overdose or reaction from multiple injections

Symptoms of an overdose or a severe reaction from multiple injections can include:

  • severe pain, redness, or itchiness in the area near the injection
  • flushing
  • hives
  • angioedema (swelling under your skin, typically in your eyelids, lips, hands, or feet)
  • swelling of your throat, mouth, or tongue
  • trouble breathing

What to do in case of overdose

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

Before taking Emgality, talk with your doctor about your health history. Emgality may not be right for you if you have the following medical history:

  • History of serious hypersensitivity reaction to Emgality. Emgality should not be used in people who’ve had a serious hypersensitivity reaction to Emgality in the past. A serious reaction involves a rash, itchy skin, and trouble breathing. This can occur hours to days after taking a dose.

When Emgality is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the package. 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 effective can depend on many factors, including how and where the medication is stored.

Emgality should be stored in the refrigerator, at a temperature between 36⁰F and 46⁰F (2⁰C and 8⁰C). It should not be frozen. Emgality can be stored at room temperature (up to 86⁰F) for as long as 7 days. Once it has been removed from the refrigerator, don’t put it back in the refrigerator.

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

The following information is provided for clinicians and other healthcare professionals.

Mechanism of action

Emgality (galcanezumab) is a humanized monoclonal antibody that blocks calcitonin gene-related peptide (CGRP) from binding to its receptor.

Pharmacokinetics and metabolism

Emgality is administered as a loading dose (2 injections of 120 mg each) to reach steady-state concentration after the first dose. Maximum concentration is achieved in five days. The injection site location does not affect absorption.

Emgality is degraded to small peptides and amino acids via catabolism. It’s not metabolized by cytochrome P450 enzymes. Elimination half-life is approximately 27 days.

Contraindications

Emgality is contraindicated in people with a history of serious hypersensitivity to galcanezumab or any of the drug’s excipients.

Storage

Emgality should be stored in the refrigerator (36⁰F/2⁰C to 46⁰F/8⁰C). Emgality’s shelf life is two years if maintained in the refrigerator. It can be stored at room temperature (up to 86⁰F/30⁰C) for up to 7 days. Once removed from the refrigerator, it cannot be placed back into the refrigerator. It should not be frozen.

Protect Emgality from light once it’s taken out of its packaging. Do not shake Emgality products.

Disclaimer: Healthline 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 other 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.