What Side Effects Are People Experiencing with CGRPs Now?

In 2018 the FDA approved three new medications to treat migraine.1 These medications are known by the brand names Aimovig, Emgality, and Ajovy. All three medications are in a class called calcitonin gene-related peptide inhibitors (CGRPs).

CGRPs developed to treat migraine

CGRPs are a type of medication called monoclonal antibodies.1 Traditional medications are usually a combination of chemical ingredients mixed together. Monoclonal antibodies are different from traditional medications because they are made of long strands of proteins. They are developed in a laboratory and often from living cells.2 CGRPs were the first monoclonal antibodies developed to treat migraine.

Keeping track of side effects

All medications have side effects. We learn about many side effects during a medication’s clinical trial phase. There may be side effects we do not know about when medications are approved for use. The United States Food and Drug Administration has a site to report side effects of approved medications.3 This is called the Food and Drug Administration Adverse Events Reporting System (FAERS).

Common side effects of CGRPs

Doctors decided to look at FAERS and see if there were any newly reported side effects in CGRPs. Here are the most common side effects that they found:3,4

  • Injection Problems: This were the most common side effect in almost all of the medications. All three medications are self-administered injections. People experienced using the wrong technique, accidental exposure, under-dosing, and even not getting any dose. These side effects can be prevented. Patients need to be properly trained in using the injection device before starting the medication. These side effects occurred in less than 0.5 percent to 0.1 percent of people who use CGRPs.
  • Injection Site Reactions: All three medications caused injection site reactions. This means that people had some kind of reaction at the place where the needle enters the skin. These reactions included pain, swelling, itching, and/or rash at the injection site. These reactions happened in 0.3 percent or less of the people who use CGRPs.
  • Headache or Migraine: Unfortunately, we know that no medication works for every person who tries it. Some people who use CGRPs still experience headaches and migraine attacks. They may also experience nausea and fatigue that is associated with migraine. These side effects occurred in less than 0.5 percent to 0.1 percent of people who use CGRPs.
  • Constipation: Constipation was a side effect listed for one of the CGRP drugs. Aimovig caused constipation in just under 0.5 percent of people who used it. Constipation was not listed in the top 10 side effects of either of the other CGRPs.

There were some concerns that CGRPs could cause heart-related issues or strokes. Heart-related issues were not listed in the top 10 side effects for any of the medications.3,4 Doctors will continue to watch for these effects as more people begin and continue to use CGRPs.

Are they right for you?

All medications can cause side effects and no medication works perfectly for everyone. You or your doctor may have been waiting to try a CGRP until there was a better understanding of the side effects.3 Since CGRPs have been out for over two years, your doctor may have more information to refer to if you have questions about this being a good option for you.

If you are concerned about injection-site reactions let your doctor know. There may be treatments that can help these side effects. Some people will also state that the benefit of minimal migraine attacks (or even being migraine free) outweighs the injection-site problems they experience.

Let your health care team know if you have concerns about using an auto-injector. Your doctor, nurse, or pharmacist should be able to teach you how to use the auto-injector properly. You may want to ask if someone can help you use it the first time you have to give yourself a dose. Your health care team may even have a patient educator who specializes in teaching you how to use your medication correctly.

Your health care team is the best resource in your migraine journey. Talk to them about the best treatments for you. Let them know any concerns you have about your current treatment plan, or any new plans you are considering. They will help you find the best resources for your needs.

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