Aimovig (erenumab-aooe) is a prescription medication approved by the FDA for the prevention of migraine headaches in adults. Administered as a subcutaneous injection, Aimovig works by blocking CGRP proteins in the brain and nervous system, which are thought to cause inflammation leading to migraine attacks. While Aimovig has proven effective for many in reducing the frequency of migraine days, understanding its potential side effects is crucial for patients and healthcare providers. This article delves into the side effects of Aimovig, with a particular focus on its relationship with weight changes, and provides a comprehensive overview of other possible adverse reactions and important considerations before starting treatment.
How Aimovig Works
Aimovig contains the active ingredient erenumab-aooe, a monoclonal antibody that belongs to the class of drugs called calcitonin gene-related peptide (CGRP) receptor antagonists. CGRP is a protein involved in causing inflammation in the brain, which can trigger migraine attacks. Aimovig functions by blocking CGRP proteins in the brain and nervous system, thus preventing migraine episodes.Aimovig is available as 70 mg or 140 mg prefilled syringes or SureClick autoinjector pens. The recommended dose of Aimovig is 70 mg injected once a month under the skin of your stomach, thigh, or upper arm. If this dose is not effective, it can be increased to 140 mg once a month.
Weight Loss and Weight Gain: Is There a Connection to Aimovig?
Clinical studies of Aimovig did not report either weight gain or weight loss as a side effect. Weight changes weren’t reported in clinical studies of people using the drug.
It's important to note that other medications used for migraine prevention are known to cause weight gain, such as tricyclic antidepressants (TCAs) like Elavil (amitriptyline) and Sinequan (doxepin), and some beta-blockers like Inderal LA (propranolol ER) and Lopressor (metoprolol). On the other hand, a different medication called topiramate (Topamax), which is also used to prevent migraine headaches, can cause weight loss.
However, there is a connection between weight and migraine episodes. Obesity may lead to an increase in the number or severity of migraine headaches. It is also possible to lose your appetite when you have migraine episodes, so that could cause you to lose weight.
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If you have concerns about losing or gaining weight during your Aimovig treatment, talk with your doctor. They can suggest ways to reach or maintain a weight that is healthy for you.
Common and Mild Side Effects of Aimovig
Aimovig can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days or weeks after an Aimovig injection. And it’s possible that after your first few months of treatment you may have fewer or milder side effects. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Some mild side effects that have been reported with Aimovig include:
- Injection site reactions
- Muscle cramps and muscle spasms (twitches)
- Mild constipation
These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Injection Site Reactions
Aimovig is given as a subcutaneous injection using an auto-injector pen or a prefilled syringe. Some people have a mild reaction in the area of the injections. This kind of reaction is possible with most injectable drugs. Injection site reactions were a common side effect of Aimovig in clinical studies.
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Examples include:
- Redness or other color changes in your skin
- Itching
- Pain
Injection site reactions are typically mild and last a day or so. Letting Aimovig come to room temperature before injecting a dose can help reduce discomfort during an injection. You should remove Aimovig from the refrigerator and let it sit at room temperature for at least 30 minutes. Keep the drug out of direct sunlight, and do not microwave it. If you find that the reactions are bothersome, talk with your doctor or pharmacist. They may be able to recommend ways to ease this side effect.
Muscle Cramps and Muscle Spasms
Muscle cramps and muscle spasms (twitches) occurred in some people in clinical studies of Aimovig, but this was a rare side effect. To help prevent and ease muscle cramps and spasms, drink plenty of water. If you’re concerned about this side effect while using Aimovig, talk with your doctor.
Constipation
Constipation was one of the more common but mild side effects of Aimovig in clinical studies. Symptoms of constipation may include abdominal pain or cramping, difficulty passing stools, and straining when trying to pass stools. To help prevent constipation, try drinking plenty of water and eating foods high in fiber. If you have constipation while using Aimovig, talk with your doctor or pharmacist. They can suggest ways to help relieve it.
Serious Side Effects of Aimovig
While Aimovig is generally considered safe, it is important to be aware of the potential serious side effects that have been reported since the drug became available on the market. The list below may not include all the possible serious side effects of the drug. For more information, you can refer to Aimovig’s prescribing information.
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Serious side effects that have been reported with Aimovig include:
- Constipation with serious complications
- High blood pressure
- Raynaud's phenomenon
- Allergic reaction
If you develop serious side effects while using Aimovig, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Constipation with Serious Complications
Severe constipation can happen after receiving Aimovig. In some cases people have been hospitalized or needed surgery. If your constipation is severe, talk with your doctor right away.
High Blood Pressure
High blood pressure or worsening of high blood pressure can happen after receiving Aimovig. High blood pressure usually doesn’t cause any symptoms. But when it becomes very high, symptoms can include headache, dizziness, and nosebleed. If you notice symptoms of high blood pressure while using Aimovig, talk with your doctor right away. If your blood pressure becomes high, your doctor may want to monitor your blood pressure at home. If it remains high, they may suggest switching you to a different medication.
Raynaud's Phenomenon
Raynaud's phenomenon is a type of circulation problem that can worsen or happen after receiving Aimovig. This phenomenon can lead to your fingers or toes feeling numb, cool, or painful, or changing color from pale, to blue, to red. Be sure to talk with your doctor before starting Aimovig. They may recommend monitoring for any worsening of your symptoms if they prescribe Aimovig.
Allergic Reactions
For some people, Aimovig can cause an allergic reaction. This can happen within hours to days after using Aimovig. Most reports of allergic reaction with Aimovig include mild allergic reactions. And most reactions occur within hours to more than a week after receiving an Aimovig injection.
Ways to manage:
- For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
- For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Aimovig, your doctor may recommend taking a different medication instead.
Precautions and Considerations Before Using Aimovig
Before starting Aimovig, it is essential to discuss your health history with your healthcare provider. Aimovig may not be right for you if you have certain medical conditions or other factors affecting your health.
Allergic Reaction
You should not use Aimovig if you’ve ever had an allergic reaction to Aimovig or any of its ingredients. Talk with your doctor about which other treatments are better choices for you.
High Blood Pressure
Aimovig may cause high blood pressure. If you already have high blood pressure, receiving Aimovig could worsen your condition. Before using the drug, talk with your doctor. They may recommend that you monitor your blood pressure at home during your treatment.
Raynaud's Phenomenon
If you have Raynaud's phenomenon, Aimovig could make it worse. In some cases, the drug could cause hospitalization and severe complications of this condition. Be sure to talk with your doctor before starting Aimovig. They may recommend monitoring for any worsening of your symptoms if they prescribe Aimovig.
Pregnancy and Breastfeeding
It’s not known if Aimovig is safe to use during pregnancy. There is a registry for pregnant women taking Aimovig that is used to collect information about you and your baby’s health. It is not known if Aimovig will pass into your breast milk. Before using Aimovig, talk with your doctor if you’re pregnant or planning on becoming pregnant, or if you’re breastfeeding or planning to breastfeed. They can advise you on the benefits and risks of the drug. If you do use Aimovig while pregnant, consider signing up for the Aimovig pregnancy registry. The pregnancy registry gathers information on how Aimovig can affect pregnancy. You can also talk with your doctor.
Alcohol and Aimovig
There are no known safety issues with drinking alcohol while using Aimovig. But for some people, drinking alcohol can trigger a migraine episode. If you know alcohol is one of your migraine triggers, you’ll likely want to avoid alcohol while using the drug. If you drink alcohol, talk with your doctor about the amount that’s safe for you to have during Aimovig treatment.
Alternatives to Aimovig
When it comes to migraine prevention, Aimovig is not the only option. If weight changes are a concern, switching to Emgality or Vyepti may be a better option, as these medications work similarly to Aimovig but have potentially different side effect profiles. Gepants, such as Nurtec and Qulipta, are also good alternatives. There is no one-size-fits-all drug for the treatment of migraine. Some people get pain relief from over-the-counter options like NSAIDs and acetaminophen or prescription drugs such as triptans. Others require preventive medications like Aimovig.
Ajovy as an Alternative
Ajovy (fremanezumab-vfrm) is another FDA-approved migraine prevention treatment for adults. Manufactured by Teva Pharmaceuticals, this calcitonin gene-related peptide inhibitor (CGRP inhibitor) is a monoclonal antibody that prevents headache pain from chronic or episodic migraine. It comes in a prefilled autoinjector pen administered by subcutaneous injection into the stomach, upper thighs, or back of the upper arms either once per month or once every three months.
Weight loss is not a possible side effect of Ajovy. According to the prescribing information, the most common side effects are injection site reactions-including skin rash, itchy skin, and hives-after administering the dose of Ajovy from the prefilled syringe. If someone does notice weight loss after starting Ajovy, there are a few possible causes. Anyone experiencing rapid weight loss after starting Ajovy treatment should consult their healthcare provider.
Migraine and Body Weight Connection
Ajovy doesn’t cause weight loss, but there is a connection between migraine disorder and body weight. Obesity is a risk factor for migraine, according to the American Migraine Foundation. Research supports that both ketogenic and low-calorie diets-1200 to 1500 [calories] per day-can significantly reduce the frequency of headaches.
Physical activity burns calories, which can lead to weight loss for people who are overweight or with obesity. Exercising 30 to 60 minutes per day, three to four days per week, has been shown to reduce migraine headaches. Dietary migraine triggers can lead to nausea, which can impact your ability to eat a healthy, well-balanced diet. If you’re not sure which foods cause or worsen your migraine attacks. Ginger ale is a popular home remedy for nausea, but it is also a sugary soda drink with lots of extra calories. “Ginger is a low-calorie food: a teaspoon of fresh ginger contains about two calories, and a quarter-cup of sliced fresh ginger has about 24 calories,” she says.
Managing Side Effects and Staying Informed
During Aimovig treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.
Your side effect notes can include things such as:
- What dose of the drug you were using when you had the side effect
- How soon after starting that dose you had the side effect
- What your symptoms were from the side effect
- How it affected your daily activities
- What other medications you were also taking
- Any other information you feel is important
Keeping notes and sharing them with your doctor will help your doctor learn more about how Aimovig affects you. And your doctor can use this information to adjust your treatment plan if needed.