erenumab (Rx)

Brand and Other Names:Aimovig

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

single-dose prefilled syringe

  • 70mg/mL
  • 140mg/mL

single-dose prefilled SureClick autoinjector

  • 70mg/mL
  • 140mg/mL

Migraine Prophylaxis

Indicated for preventive treatment of migraines

70 mg SC once monthly

Some patients may need 140 mg SC once monthly (administered as 2 consecutive 70-mg SC doses)

Dosage Modifications

Renal or hepatic impairment is not expected to affect pharmacokinetics of erenumab

Hepatic impairment: Not studied

Renal impairment

  • Mild-to-moderate: Clinical studies did not reveal a difference in pharmacokinetics
  • Severe (eGFR <30 mL/min/1.73 m²): Not studied

Safety and efficacy not established

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Interactions

Interaction Checker

and erenumab

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (3)

                • efgartigimod alfa

                  efgartigimod alfa will decrease the level or effect of erenumab by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.

                • efgartigimod/hyaluronidase SC

                  efgartigimod/hyaluronidase SC will decrease the level or effect of erenumab by receptor binding competition. Use Caution/Monitor. Coadministration of efgartigimod with medications that bind to the human neonatal Fc receptor may lower systemic exposures and effectiveness of such medications. Closely monitor for reduced effectiveness of medications that bind to the human neonatal Fc receptor. If long-term use of such medications is essential, consider discontinuing efgartigimod and using alternative therapies.

                • rozanolixizumab

                  rozanolixizumab will decrease the level or effect of erenumab by receptor binding competition. Use Caution/Monitor. Rozanolixizumab may lower systemic exposures and reduce effectiveness of medications that bind to the human neonatal Fc receptor (FcRn). Closely monitor for decreased efficacy of such medications. When long-term use of such medications is required, consider discontinuing rozanolixizumab and using alternative therapies.

                Minor (0)

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                  Adverse Effects

                  1-10%

                  Injection site pain (5-6%)

                  Constipation (1-3%)

                  Cramps, muscle spasms (<3%)

                  Postmarketing Reports

                  Immune system disorders: Rash, angioedema, anaphylaxis, hypersensitivity

                  Gastrointestinal disorders: Oral mucosal ulceration, constipation with serious complications

                  Vascular disorders: Hypertension

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                  Warnings

                  Contraindications

                  Hypersensitivity to drug or excipients

                  Cautions

                  Hypersensitivity reactions (eg, rash, angioedema, anaphylaxis) reported; may occur within hours or one week following administration; discontinue administration and initiate appropriate therapy if serious reaction occurs

                  Hypertension

                  • Development of hypertension and worsening of pre-existing hypertension reported
                  • Pre-existing hypertension or of risk factors increases risk
                  • Pharmacological treatment may be necessary
                  • May occur at anytime but most frequently within seven days of dose administration
                  • Onset or worsening of hypertension usually reported after first dose
                  • Monitor for new onset or worsening of pre-existing hypertension and consider whether discontinuation of therapy warranted if no alternate etiology found

                  Constipation

                  • Constipation with serious complications reported in the postmarketing setting; cases that required hospitalization, including cases where surgery was necessary reported
                  • In majority cases, onset of constipation was reported after first dose; however, patients have also presented with constipation later on in treatment
                  • Monitor patients for severe constipation and manage as clinically appropriate
                  • Concurrent use of medications associated with decreased gastrointestinal motility may increase risk for more severe constipation and potential for constipation-related complications
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                  Pregnancy

                  Pregnancy

                  Data are not available regarding fetal risk if used in pregnant women

                  Animal studies

                  • No adverse effects on offspring were observed when pregnant monkeys were administered erenumab-aooe throughout gestation

                  Clinical considerations

                  • Data suggest that women with migraine may be at increased risk of preeclampsia and gestational hypertension during pregnancy

                  Lactation

                  Data are not available on the presence in human milk, the effects on the breastfed infant, or the effects on milk production

                  Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Human monoclonal antibody; binds to the calcitonin gene-related peptide (CGRP) receptor, which is thought to be causally involved in migraine pathophysiology

                  Absorption

                  Absolute bioavailability: 82%

                  Peak plasma time: ~6 days

                  Peak plasma concentration: 6.1 mcg/mL (70 mg); 15.8 mcg/mL (140 mg)

                  AUC: 159 day·mcg/mL (70 mg); 505 day·mcg/mL (140 mg)

                  Bioavailability: 82%

                  Distribution

                  Vd: 3.86 L

                  Elimination

                  Half-life: 28 days

                  2 elimination phases observed

                  • Low concentrations: Predominantly through saturable binding to target (CGRP receptor)
                  • Higher concentrations: Largely through a nonspecific, nonsaturable proteolytic pathway
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                  Administration

                  SC Administration

                  For SC use only

                  Needle shield within cap of prefilled autoinjector and cap of prefilled syringe contain dry natural rubber (a derivative of latex) may cause allergic reactions in latex-sensitive individuals

                  Intended for self-administration; properly train on preparation and administration, including aseptic technique

                  Before SC administration, allow syringe or autoinjector to sit at room temperature for at least 30 minutes protected from direct sunlight

                  Do not warm by using a heat source (eg, hot water, microwave)

                  Do not shake product

                  Visually inspect for particulate matter and discoloration; do not use if solution is cloudy or discolored or contains particles

                  Administer SC in the abdomen, thigh, or upper arm; do not inject into areas where skin is tender, bruised, red, or hard

                  Prefilled autoinjector and syringe are single-dose and deliver entire contents

                  Missed dose

                  • Administer as soon as possible: reschedule monthly dose from date of last dose

                  Storage

                  Refrigerate at 2-8ºC (36-46ºF) in original carton to protect from light

                  If removed from refrigerator, store at room temperature (up to 25ºC [77ºF]) in original carton for up to 7 days; discard if left at room temperature for >7 days

                  Do not freeze

                  Do not shake

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                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  Aimovig Autoinjector subcutaneous
                  -
                  70 mg/mL syringe
                  Aimovig Autoinjector subcutaneous
                  -
                  140 mg/mL syringe

                  Copyright © 2010 First DataBank, Inc.

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                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
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                  Formulary

                  FormularyPatient Discounts

                  Adding plans allows you to compare formulary status to other drugs in the same class.

                  To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                  Adding plans allows you to:

                  • View the formulary and any restrictions for each plan.
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                  • Compare formulary status to other drugs in the same class.
                  • Access your plan list on any device – mobile or desktop.

                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.