Injectable migraine medications can help prevent migraine episodes and alleviate symptoms during an attack. Most are intended for migraine prevention, but some can help stop a migraine attack.

Share on Pinterest
Guido Mieth/Getty Images

Injectable migraine medications include older medications, such as sumatriptan (Imitrex), as well as newer options such as calcitonin gene-related peptide (CGRP) inhibitors. Injectable options are available to help both reduce symptoms when they strike and prevent future migraine episodes. But each treatment works slightly differently.

In 2018, the Food and Drug Administration (FDA) approved the first CGRP medication. This injectable drug was the first medication specifically designed to prevent episodic and chronic migraine. All previous migraine treatments were initially developed to treat other conditions.

CGRP is a protein in the brain and nervous system. When levels of this protein are elevated, it may trigger a migraine attack. CGRP inhibitors work by lowering the amount of CGRP circulating throughout your body. They do this by preventing CGRP proteins from binding to CGRP receptors.

Research shows CGRP medications help reduce:

  • the frequency of migraine attacks
  • the number of headache days during an episode
  • the need for medication during a migraine attack

Three types of CGRPs are available as an injection to help prevent migraine episodes. Each is available in a premeasured injectable pen. You place the pen against your body and press a button to administer the injection.

Erenumab (Aimovig)

Erenumab (Aimovig) is a self-administered injection you take at home once a month. You should start to notice improvements within the first month of treatment.

Research shows that erenumab can lower the number of severe headache days experienced each month by 50%.

You’ll need to continue taking erenumab each month to maintain these results.

Fremanezumab (Ajovy)

Fremanezumab (Ajovy) is also a self-administered injection you take at home either once a month or once every 3 months, depending on the dose you take. You should start to experience improvements after the first month.

Studies show that fremanezumab reduces the number of overall headache days each month by 63%.

You’ll need to continue taking fremanezumab each month to maintain these results.

Galcanezumab (Emgality)

Galcanezumab (Emgality) is another self-administered injection you take at home once a month. You should start to experience improvements within the first month of treatment. But some people experience benefits within the first week.

Research shows that, not only does galcanezumab reduce the frequency of migraine headache days, but it also provides relief from migraine symptoms such as nausea and sensitivity to light. You’ll need to continue taking galcanezumab every month to maintain these results.

Eptinezumab (Vyepti)

Eptinezumab (Vyepti) is a CGRP monoclonal antibody that has been shown to reduce the number of headache days and lower pain intensity.

Unlike other CGRP injections that are taken at home, eptinezumab is given as an intravenous (IV) infusion. You’d get an infusion, which takes about 30 minutes, once every 3 months. Research shows that it’s well-tolerated by most people, with few side effects.

Talk with a doctor to determine if a CGRP medication is right for you. If you prefer noninjectable medications, other CGRPs options can be given orally or as a nasal spray.

Botox is another injectable treatment used for chronic migraine prevention. A doctor injects Botox into several places on your forehead and neck. It prevents a migraine episode by blocking the release of chemicals in the head that transmit pain.

It may take multiple rounds of injections over the course of up to 6 months before you reach the maximum benefit of Botox. Results from Botox may last for 10–12 weeks. You need to keep getting the injections to maintain results.

Talk with a doctor if you’d like to try Botox injections to prevent migraine.

Other injectable medications can be given to help alleviate symptoms during a migraine episode. These include sumatriptan and dihydroergotamine.

These medications constrict your blood vessels, which helps lower pain during a migraine episode. They’re meant to be taken as needed for immediate symptom relief. They’re not intended for migraine prevention or regular use.

Other options

While all CGRP medications can help prevent migraine episodes, certain CGRPs can also help alleviate symptoms during an attack. These medications are taken as needed during a migraine attack. They’re primarily available as pills rather than injections.

These include:

Zavegepant (Zavzpret) is another CGRP that’s administered as a nasal spray during a migraine attack.

Injectable medications for migraine prevention can come with side effects, but they’re relatively minimal. Generally speaking, the benefits of these drugs outweigh the risks of side effects.

CGRP medications are generally well tolerated. The most common side effect is pain at the injection site. Other side effects may include constipation, fatigue, nausea, or upper respiratory tract infection.

The most common side effect from Botox injections is soreness at the injection site. Applying an ice pack to the affected area can help alleviate injection site discomfort.

Injectable drugs for migraine prevention can be costly without insurance coverage.

  • CGRP injections can cost $7,000 each year.
  • Botox may cost up to $600 for each round.

Various factors can affect the out-of-pocket costs of migraine medication. While many insurance plans do cover the costs of these drugs, some require you to try other drugs first before moving on to injections. Or you may need prior approval before coverage is provided.

You might also want to check out savings programs and coupons offered by drug companies, as these can significantly cut down your out-of-pocket costs.

Various medications are available to both treat symptoms during a migraine attack and prevent future episodes. It’s important to work with a doctor to determine if injectable drugs may be a good option to include in your migraine treatment plan.