Fremanezumab
AJOVY
Pronunciation: free-ma-NEZ-yoo-mab (a-JOE-vee)
“Freeman zooms (on an) Anchovy”
What it isCGRP ligand antibody; migraine prevention.
Why this oneThe only injectable CGRP ligand antibody offering a quarterly subcutaneous regimen as well as monthly dosing.
What limits itInjection-site reactions are common. Response takes time; cost and prior authorization are practical barriers.
Fremanezumab prescription history
Animated chart of estimated U.S. prescriptions per year, Migraine-specific meds (1936–2026). Fremanezumab enters in 2018 (estimated).
FDA-approved for
- migraine prophylaxis (2018)
Principal riskInjection-site reactions
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityInjection reactions and hypersensitivity; acute overdose toxicity is low.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Migraine prevention | Adults | 225 mg monthly or 675 mg q3mo | 225 mg monthly or 675 mg q3mo | |
| Episodic migraine prevention | Peds 6–17 yr, ≥45 kg | 225 mg monthly | 225 mg monthly |
Renal Undefined
Hepatic Undefined
Instructions
- Subcutaneous only — abdomen, thigh, or upper arm
- 675 mg quarterly dose given as three consecutive 225 mg injections
Available strengths
- inj 225 mg/1.5 mL
Cautions
- Hypersensitivity reactions (anaphylaxis, angioedema)
- Constipation with serious complications
- Hypertension (new-onset or worsening)
- Raynaud's phenomenon
Adverse reactions
- Injection site reactions
Pregnancy No adequate human data; long half-life; no adverse developmental effects in animals
Lactation No human data
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 225 mg/1.5 mL | inj | per unit | — | $508.17/mL | not offered |
Generic entry2034 est. (biosimilar)
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Memory aids: interaction avatars
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Self-check
- Which less-frequent SC schedule does fremanezumab offer?
Quarterly. - What common local reaction occurs with fremanezumab?
Injection-site reactions.