Emgality (Galcanezumab) For Migraines: What To Expect

Migraine headaches cause intense, throbbing, severe pain, typically on one side of the head. Migraine can be mild and infrequent. However, a severe migraine can interfere with your ability to function in daily life. In 2019, the U.S. Food and Drug Administration (FDA) approved Emgality (galcanezumab-gnlm) as the preventive treatment for chronic migraines and certain types of headaches. Emgality is available as a once-monthly self-injection. This medication is also approved to treat episodic cluster headaches. Please continue reading to learn more about Emgality.

Is Emgality indicated for chronic migraine?

Emgality is FDA-approved for the prevention of chronic migraine and for the treatment of episodic cluster headache. The active ingredient, galcanezumab-gnlm, is a monoclonal antibody, which is a man-made antibody that acts like natural antibodies in the immune system. Emgality is a calcitonin gene-related peptide (CGRP) inhibitor. The release of the protein CGRP can lead to intense inflammation in the meninges (the coverings of the brain), causing the pain associated with migraine attacks. CGRP inhibitors like Emgality block the calcitonin gene-related peptide from binding to the CGRP receptor, thereby preventing migraines and cluster headaches.

How does Emgality make you feel?

Used once monthly, Emgality can help prevent episodic migraine symptoms before they start. This medicine can reduce the number of monthly migraine days and the frequency of cluster headache attacks in people with cluster headaches. Fewer migraine episodes and cluster headaches will result in fewer sick days from work and school and improve a person’s quality of life at the same time. Preventive treatments like Emgality can also help lower your risk of medication overuse headache by reducing your need to take other medications to control headache symptoms.

What is the Emgality dose for migraine prevention?

To prevent migraine headaches in adults, Emgality is administered as a 240-mg dose initially. This 240-mg loading dose is given with two 120-mg prefilled syringes or pens administered as two consecutive subcutaneous injections. This initial dose of 240 mg is followed by a monthly dose of 120 mg.

What is the Emgality dose to treat cluster headaches?

The usual dose of Emgality for episodic cluster headache is a 300 mg dose (administered as three injections of 100 mg each) at the start of a cluster period, followed by 100 mg monthly injections until the cluster period ends.

How to use Emgality?

Emgality (galcanezumab-gnlm) comes as an injectable solution in prefilled syringes or pens. This medicine is to be injected subcutaneously (under the skin) once a month. You may get the first dose (consisting of two 120-mg injections for chronic migraine or three 100-mg injections to treat cluster headaches) in your doctor’s office. Thereafter, Emgality injection can be self-administered monthly. If you have dexterity problems, friends or family members can be educated on the injection techniques so they can help administer this medication for you.

Emgality prefilled injection pens and syringes should be stored in the refrigerator (not the freezer). Take one pen or syringe out and keep it at room temperature for around 30 minutes before use. Do not keep the pen or syringe in direct sunlight or put it in hot water or a microwave to warm it quickly.
Make sure the injection solution is colorless or slightly yellow or brown. Do not use the medicine if you can see solid particles or flakes in the injection solution. Do not shake the prefilled pen or syringe.
Inject Emgality into the back of your upper arm or into your thigh, buttock, or stomach area. Do not inject in an area with broken, cut, hard, tender, red, swollen, or inflamed skin.
Use each Emgality pen or syringe only once. Dispose of the used syringe or injection pen in a puncture-resistant container (ask your doctor or pharmacist to show you how to dispose of used pens and syringes correctly).
Make sure you inject all the solution in the prefilled pen or syringe.
Try to inject the medicine on the same day every month. If you miss one dose, use the next dose one month later. Do not double the dose to make up for the missed dose.
Keep in mind that Emgality dose is based on the condition being treated. Therefore, you must use the exact dose prescribed by your doctor.
Read the prescription label carefully. Do not change the dose, dosing frequency, or duration of treatment without your doctor’s approval.

What to expect from Emgality?

Injection site reactions

Common side effects of Emgality include painful, red, swollen, and itchy skin at the injection site. Tell your doctor if the injection site reactions are severe or do not go away in a few days.

Serious adverse effects

Rarely, taking Emgality can cause a serious reaction, including an allergic reaction. Call your doctor immediately or seek emergency medical care if you develop a skin rash, hives, itching, swelling of the face, eyes, lips, tongue, or throat, trouble breathing, or shortness of breath.

How long does it take to see results from Emgality?

Emgality does not work immediately to prevent migraine headaches. It may take up to 5 or 6 months to experience the full effects of Emgality. However, you may see a reduction in the number of migraine days about one month after starting this medicine.

When used to treat cluster headaches, Emgality starts working within one week. However, it can take up to three weeks to experience the full effects.

What precautions should I take during galcanezumab preventive treatment?

Allergic reactions

Tell your doctor if you have a history of hypersensitivity reactions to the Emgality (galcanezumab) injection, any of the active or inactive ingredients in galcanezumab injections, or other preventive medications for migraine. People with a history of an allergic reaction to Emgality should not take this medicine again.

Drug interactions with other medicines

Give your doctor a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal products. This will help prevent potentially dangerous drug interactions between Emgality and your other drugs.

Medical history

Give your healthcare professionals a complete health history. Emgality may not be right for people with a certain medical condition. Before starting treatment, tell your healthcare professional if you are pregnant or breastfeeding. Call your doctor if you become pregnant during treatment.

Storage

Emgality prefilled injection pens and syringes should be stored in the refrigerator (do not freeze them). They can be stored at room temperature for up to 7 days.

Can you take Emgality long term?

There are no known long-term side effects from Emgality. If the medication is working well for you to prevent migraine, your healthcare provider may ask you to continue taking it long-term. If you are taking Emgality to treat cluster headaches, you will take it monthly until the end of your cluster period.

Is Emgality successful?

Two 6-month studies on patients with episodic migraines and a 3-month study on patients with chronic migraines were used to evaluate the efficacy of Emgaity as a preventive treatment of episodic or chronic migraine.

Two six-month studies that enrolled people with 4-14 migraine days per month found that taking Emgality for migraine prevention reduced migraine days by 75%. Some people even had a 100% reduction in migraine days for at least one month. However, a 3-month study in people who had 15 or more monthly migraine headache days found that the 75-100% reduction in the number of migraine days achieved with Emgality was no different than the group taking a placebo.

Within these two 6-month studies, it was found that at 6 months, 59% to 62% of participants achieved at least 50% reduction in the number of headaches; 34% to 39% achieved at least 75% reduction in the number of headaches.

Is Emgality expensive?

The list price for one injection of Emgality (120 mg prefilled pen or syringe) is $679.20. The actual cost will depend on your insurance plan. A discount coupon from BuzzRx can help you save up to 80% on Emgality prescription.

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