Erenumab
AIMOVIG
Pronunciation: e-REN-yoo-mab (AYM-oe-vig)
“Aim (at) moving Errant noob”
What it isCGRP receptor antibody; migraine prevention.
Why this oneThe only marketed CGRP monoclonal antibody that blocks the receptor rather than the ligand.
What limits itConstipation can be severe, and blood pressure can rise. Cost and prior authorization are practical barriers.
Pearls
- Can work when other preventives have failed.
- Effective off-label for menstrual migraine.
Erenumab prescription history
Animated chart of estimated U.S. prescriptions per year, Migraine-specific meds (1936–2026). Erenumab enters in 2018 (estimated).
FDA-approved for
- migraine prophylaxis (2018)
Principal riskConstipation, which can be severe; hypertension
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityConstipation and hypertension are the principal serious concerns; acute overdose toxicity is low.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Preventive treatment of migraine | adult | 70 mg SC once monthly | 70 mg SC once monthly; some patients 140 mg once monthly | 140 mg once monthly |
Renal Undefined
Hepatic Undefined
Instructions
- Subcutaneous use only (abdomen, thigh, or upper arm)
- Before use, let sit at room temperature >=30 min protected from sunlight; do not warm or shake
- Patient self-administration via single-dose prefilled autoinjector or syringe
- If a dose is missed, give as soon as possible, then schedule monthly from the last dose
Available strengths
- inj 70, 140 mg/mL
Cautions
- Hypersensitivity reactions (rash, angioedema, anaphylaxis) — may occur hours to >1 week after dosing
- Constipation with serious complications (some requiring hospitalization/surgery)
- New-onset or worsening hypertension
- New-onset or worsening Raynaud's phenomenon
Adverse reactions
- Injection-site reactions
- Constipation
Pregnancy No adequate human data; animal studies showed no adverse effects on offspring.
Lactation No data on presence in human milk; weigh benefits against clinical need.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 70 mg/mL | inj | per unit | — | $753.57/mL | not offered |
| 140 mg/mL | inj | per unit | — | $753.33/mL | not offered |
Generic entry2034 est. (biosimilar)
Open Erenumab in the interactive console ↗
Memory aids: interaction avatars
Open Erenumab in the interactive console ↗
Self-check
- Does erenumab target CGRP or its receptor?
The receptor. - Which bowel adverse effect can be severe with erenumab?
Constipation.