Aimovig (erenumab)

Aimovig is a preventive treatment for migraine. It is part of a class of medications called calcitonin gene-related peptide (CGRP) monoclonal antibodies.

CGRPs and other preventive treatments are often recommended for people living with chronic or debilitating migraine attacks. There are lots of options for preventive treatments, so it can be helpful to know what is available before speaking to your doctor. 

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Medically reviewed by Dr Trudy Cheng. Last updated February 5, 2023.

What is Aimovig?

Aimovig (erenumab) is a preventive migraine medication. It is one of the four calcitonin gene-related peptide (CGRP) monoclonal antibodies available in Australia. The other CGRPs are Ajovy, Emgality, and Vyepti.

Migraine is a neurological disorder that can be debilitating. It can cause a variety of symptoms such as head pain, nausea, light/sound sensitivity, visual disturbances, cognitive changes, and more.

Some people find that they can manage their migraine attacks with over-the-counter medication. But if you have chronic or debilitating attacks, your doctor might recommend that you take a preventive treatment such as Aimovig.

Aimovig medication image
Credit: Shutterstock / Simone Hogan

At a glance

Brand nameAimovig
Active ingredientErenumab
ManufacturerNovartis Australia
Dosage70 mg or 140 mg per month
AdministrationSubcutaneous injection (self-administered)
AvailabilityPrescription-only
Cost per 140 mg dose$695
PBS Status?Private prescription only (PBS application withdrawn in November 2019)

Cost & access in Australia

Aimovig is available in Australia for the preventive treatment of migraine in adults. It is a prescription medication so you will need to see your neurologist to access it. If you are not seeing a neurologist at the moment, you can find one in our doctor directory.

Unfortunately Aimovig is not available under the Pharmaceutical Benefits Scheme (PBS). After several failed attempts, Novartis withdrew their application in November of 2019.

The cost for 140 mg of Aimovig (two x 70 mg pens) is $695. You can order this online and it will be shipped to a pharmacy of your choice for pickup. At this stage, Novartis is not offering any free trials or discount programs.

Side effects

Like most medications, Aimovig can cause side effects. In most cases these will be minor and will subside in a short period of time (1). However, more serious complications or allergic reactions are possible which require immediate medical attention.

Keep in mind that side effects can vary depending on your age, other health conditions you might have, or other medications you take.

Mild side effects (1) 

  • Constipation
  • Feeling more tired than normal
  • Blocked or runny nose, cough
  • Itching
  • Muscle spasms
  • Injection site reactions (i.e. pain, redness and/or swelling)
  • Hair loss
  • Mouth or lip sores

Speak to your doctor if you have any of these less serious side effects and they worry you.

Serious side effects (1)

  • Sudden signs of allergy, i.e. rash, swelling, difficulty breathing.
  • Severe constipation, or constipation with severe or constant belly pain, vomiting, swelling of the belly, or bloating.

Call your doctor immediately or seek emergency medical attention in a hospital if you experience any of these serious side effects.

In three studies assessing the safety and efficacy of Aimovig, the most common & significant side effects were injection site reactions, constipation, and cramps/muscle spasms (2). These were the only side effects that were reported in 2% or more of patients, and were at least 2% more common in people receiving Aimovig compared to placebo.

Graph showing the likelihood of certain side effects from Aimovig
Source: Amgen, 2022, What are the possible side effects of Aimovig? (2)

Other side effects could occur in some people. After receiving medical advice about any side effects you experience, you or your neurologist can report them to the Therapeutic Goods Administration.

How it works

Aimovig is part of a group of drugs called calcitonin gene-related peptide (CGRP) monoclonal antibodies. These are the newest type of preventive migraine medication, and the first preventive treatment to be designed specifically for migraine. Other preventive treatments were all initially designed for other conditions (i.e. epilepsy, depression) and were later found to have an effect in migraine.

CGRP is a protein in the brain that is thought to play a key role in migraine. When CGRP molecules bind to receptors, this contributes towards the series of events involved in a migraine attack.

Aimovig is designed to bind to the CGRP receptor  which prevents the CGRP molecules from binding to receptors. This helps to reduce the frequency and severity of migraine.

Diagram of CGRP and receptor
1. CGRP molecules attach to the CGRP receptor. (Source: Amgen, 2022, How does Aimovig work? (5))
Diagram showing CGRP binding to receptor and causing migraine pain
2. When CGRP binds to the receptor, this contributes towards a migraine attack.
Aimovig blocks CGRP receptor to prevent binding.
3. Aimovig binds to the CGRP receptor, preventing CGRP molecules from binding to it.

Dosage

Aimovig comes in an autoinjector pen that contains either 70 mg or 140mg. The standard dose is 70 mg every 4 weeks. However, your doctor might decide that you need a higher dose, which is 140 mg every 4 weeks. This can be administered as either two 70 mg injections, or one 140 mg injection (1).

Aimovig is most effective if you take it on the same day every four weeks, so it could be helpful to set a reminder or mark the day in your calendar. If you forget to take a dose, inject it as soon as possible and resume the four week count from that day. Speak to your doctor if you’re not sure what to do.

You should see your doctor after 8-12 weeks on Aimovig to assess your progress and make sure you are on the right dose. They will also check that you are not experiencing any negative side effects. Continue seeing your doctor every three to six months while you are on Aimovig so you can monitor your progress.

How is Aimovig administered?

Aimovig is injected subcutaneously (under the skin) with an autoinjector pen. An autoinjector is a spring-loaded device that makes it easy and safe for people to inject medications at home. It can be injected in your thigh, abdomen, or upper arm.

A medical professional will teach you how to self administer this safely. If you are uncomfortable with self administration, your family member, GP, nurse or neurologist could help with this. Detailed instructions about how to use Aimovig are also available in the Consumer Medicine Information leaflet.

Generic diagram of autoinjector
Credit: Shutterstock

Here are a few things to keep in mind when injecting Aimovig:

  • Hygiene & safety are essential. Check that the medication is not damaged or expired, wash your hands, and clean the injection site with an alcohol wipe before injecting.
  • You might experience side effects. Injection site reactions like pain, redness and itching are quite common and not a cause for concern. Keep a cold compress or ice pack at hand in case you experience these symptoms.
  • Dispose of sharps safely. Unlike regular syringes, autoinjector pens don’t have an exposed needle – but they still need to be put in a sharps disposal container.

How effective is Aimovig?

Just like other migraine preventives, the efficacy of Aimovig can vary from person to person. Some might find it very effective, while others might find it doesn’t help much at all. 

Two clinical trials were conducted to measure the safety and efficacy of Aimovig in episodic and chronic migraine. Both studies found that Aimovig caused a clinically significant reduction in migraine days. You can see some of the study results in the tables below.

Episodic migraine (4)

Placebo (n = 316)70mg dose (n = 312)140mg dose (n = 318)
Average migraine days per month at baseline8.238.298.34
Average migraine days per month during treatment6.45.064.67
Average reduction in migraine days‒1.83‒3.23‒3.67
Percentage of patients with 50% or more reduction in monthly headache days26.2%43.3%50.0%

Source: Clinical Trial Identifier NCT02456740 (3)

Chronic migraine (5)

Placebo (n = 267)70mg dose (n = 178)140mg dose (n = 182)
Average migraine days per month at baseline18.2217.8517.78
Average migraine days per month during treatment14.0411.2111.15
Average reduction in migraine days‒4.18‒6.64‒6.63
Percentage of patients with 50% or more reduction in monthly headache days23.5%39.9%41.2%

Source: Clinical Trial Identifier NCT02066415 (4)

If you try Aimovig (or any other CGRP monoclonal antibodies) and you don’t find it effective, don’t be discouraged. Some people will not respond to one CGRP monoclonal antibodies but find another very helpful. You can discuss your options with your doctor.

Other considerations & interactions

Many drugs can be affected by other medications, health conditions, or lifestyle factors. These are called interactions. In some cases they just cause the drug to be less effective, but other times they can be harmful or unsafe.

Generic image of supplements as an example of interactions

At this stage, Aimovig does not have any known interactions. CGRP monoclonal antibodies are less likely to interact with other medications or supplements because they are processed by your cells. Most other medications are metabolised by enzymes in your liver.

However, just because there are no known interactions, that doesn’t mean they don’t exist. You should tell your doctor about any other medications or supplements you are taking.

Some other considerations for Aimovig include (1):

  • High blood pressure. Aimovig can cause high blood pressure, so if your blood pressure is already elevated you need to consult your doctor.
  • Allergies (including latex). The autoinjector includes a type of rubber that is similar to latex, so it can be dangerous for people with severe latex allergies. Consult the Consumer Medicine Information leaflet for a full list of ingredients and possible allergens.
  • Children and adolescents under 18. Aimovig has not been tested in this age group, and cannot be prescribed for people under 18.
  • Pregnancy and breastfeeding. Aimovig has not been studied in pregnancy, and it is not known if the ingredients can pass into breast milk. 

You should consult your doctor if any of the above factors apply. They will help you make a decision about whether or not you should take this medication.

Further information & resources

If you’d like to learn more about anything in this article, you can check out the following resources:

References:

  1. Therapeutic Goods Administration, 2022, ARTG ID 289959 [AIMOVIG erenumab Consumer Medicine Information (CMI) Summary]. Retrieved from: https://www.tga.gov.au/resources/artg/289959 
  2. Amgen, 2022, What are the possible side effects of Aimovig?. Retrieved from: https://www.aimovig.com/about/possible-side-effects 
  3. Amgen, 2022, Study to Evaluate the Efficacy and Safety of Erenumab (AMG 334) in Migraine Prevention (STRIVE). Retrieved from: https://clinicaltrials.gov/ct2/show/results/NCT02456740 
  4. Amgen, 2022, A Study to Evaluate the Efficacy and Safety of Erenumab (AMG 334) in Chronic Migraine Prevention. Retrieved from: https://clinicaltrials.gov/ct2/show/results/NCT02066415 
  5. Amgen, 2022, How does Aimovig work?. Retrieved from: https://www.aimovig.com/about/how-does-aimovig-work
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