The Migraine process generates three neurochemicals, Neurokinan A, Substance P, and CGRP.  These neurochemicals are released by the ganglia of the trigeminal nerve and cerebral arteries.  The neurochemicals inflame the trigeminal nerve, the cerebral arteries, and the thalamus. They also cause the cerebral arteries to dilate.  The thalamus is the “pain center” of the brain and only Migraine patients have inflammation of the thalamus like Migraine does.

Read my article, “The Migraine Timing Cycle,” on my website, www.doctormigraine.com.

There is a need for a drug providing better preventive therapy for Migraine than what what has been available.

This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, Migraine textbook author, blogger, podcaster, and YouTube video creator.

Ajovy (fremanezumab) is an antibody to CGRP, the main neurochemical involved in the Migraine process. Ajovy provides 50-100% reduction of Migraine attacks, has few side effects, is given by subcutaneous injection, and has no contraindicated drugs. It is a subcutaneously injected medicine for Migraine prevention in adults used monthly.

Read my Mini Migraine book Here.

Related questions

What about older drugs for Migraine prevention?

Previously available preventive drugs for Migraine work indirectly on the Migraine process and have considerable side effects. Older preventive drugs are propranolol, depakote, amitriptyline, and topiramate. They only reduce Migraine attacks by 30-40%. There is been a need for something better for Migraine prevention—Ajovy is the answer.

Learn more about “When to Start P:reventive Therapy for Migraine?” Then, read my webpage post about this at www.doctormigraine.com. Click here to read.

What are the results of AJOVY with Episodic and Chronic Migraine?

Over the course of 12 weeks, patients taking AJOVY experienced an average of 4-5 fewer headache days per month* with quarterly or monthly dosing† (vs 2-3 for placebo).

How is AJOVY dosed?

Ajovy is given as a subcutaneous injection in the thigh or near the umbilicus. Dosing may be 225 mg once a month or 225mg once every 3 months.

What are the contraindications of Ajovy?

A hypersensitivity reaction with symptoms of itching, rash, and hives within hours or up to 1 month.

If this develops the patient should notify her doctor and the drug should be stopped.

What are the adverse reactions to using Ajovy?

Common reactions are an injection site reaction, rash, pruritus, or urticaria.

Ajovy has no drug reactions with other medication.

No routine tests are indicated.

Caution is advised for use during pregnancy or breastfeeding.

Check here to learn about “Side Effects of Preventive Treatment Migraine Drugs.” The article is on my website at www.doctormigraine.com. Please click here to read.

How does Ajovy work?

Ajovy is a monoclonal antibody which works directly to block calcitonin gene-related (CGRP) activity.

Research involving cannulating the jugular vein and sampling chemicals in the blood as it leaves the brain has revealed that these neurochemicals are released by the migraine process.  After migraine starts there is an increase in the 3 inflammatory neuropeptides, and they go to the liver and then out of the body to the toilet.

Is Ajovy similar to previously used Migraine preventive drugs?

Ajovy is a new and unique drug which works within the Migraine metabolic process, blocking CGRP. None of the older preventive drugs do this. Ajovy has mild side effects, no contraindication with any other drug, and can reduce Migraine attacks by at least 50-75% in most persons. Occasional patients have complete (100%) reduction in their Migraine attacks. Ajovy may be able to give more days without migraine. 

Product information states:

Store AJOVY in the refrigerator between 36°F to 46°F (2°C to 8°C). Do not freeze.

Learn more about “CGRP Drugs For Migraine Prevention.” Read this article on my website at www.doctormigraine.com. Please click here to read.

Is Ajovy an acute therapy drug for Migraine?

Ajovy is not an acute therapy drug for Migraine but rather is a prophylactic or preventive drug. The best acute therapy drugs for Migraine are one of the 7 triptans. If a triptan is taken early in the migraine process, it will block the release of these inflammatory neurochemicals yielding 70-80% of Migraine patients headache free at 2 hours. Triptans may be used along with Ajovy.

Summary

Ajovy is a welcome addition to available drugs for Migraine prevention.

Check out my Big Book on Migraine Here.

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All the best.

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Britt Talley Daniel MD