Emgality (galcanezumab-gnlm) is a medication approved by the Food and Drug Administration (FDA) for the prevention of migraine episodes in adults and the treatment of episodic cluster headaches. While generally well-tolerated, it's essential to understand the potential side effects associated with its use, including the possibility of weight changes after discontinuing the medication.
Common and Mild Side Effects of Emgality
Clinical trials have indicated that the most common side effect of Emgality is a reaction at the injection site. Other mild side effects that have been reported include mild allergic reactions. These side effects are often temporary, resolving within a few days to weeks. If these side effects persist, worsen, or become bothersome, consulting with a doctor or pharmacist is recommended.
Serious Side Effects and Considerations
Although Emgality is unlikely to cause serious side effects, it's crucial to be aware of the potential risks. These include severe allergic reactions, high blood pressure, and Raynaud phenomenon (reduced circulation in the extremities). If any of these serious side effects occur, seeking immediate medical attention is essential.
Long-Term Side Effects of Emgality
Currently, Emgality is not known to cause any long-term side effects. However, as with any medication, ongoing monitoring and post-market surveillance are essential to identify any potential long-term effects that may emerge over time.
Weight Changes and Emgality
Clinical trials of Emgality did not identify weight change as a side effect. The drug is not known to cause weight gain or weight loss. However, anecdotal reports and post-market observations can sometimes reveal potential associations that were not evident during initial clinical trials.
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Expert Opinions and Emerging Evidence
Dr. Lawrence Robbins of the Robbins Headache Clinic notes that some headache providers consider CGRP monoclonals like Emgality to be safe with infrequent adverse effects. However, he also acknowledges that post-approval evidence suggests potential adverse effects, including weight gain or loss, among others. Thomas Moore, an expert in drug adverse effects, published a review in QuarterWatch, utilizing FDA reports and post-approval studies, further emphasizing the importance of ongoing monitoring.
Potential Weight Loss After Stopping Emgality
While not a commonly reported side effect, weight loss after stopping Emgality could potentially occur due to several factors:
- Resolution of Underlying Conditions: If Emgality was contributing to fluid retention or other metabolic changes, discontinuing the medication might lead to a resolution of these issues, resulting in weight loss.
- Changes in Lifestyle: Individuals may adopt healthier lifestyle habits, such as improved diet and increased physical activity, after stopping Emgality, contributing to weight loss.
- Medication Interactions: Emgality may interact with other medications, and stopping it could alter the effects of those medications, potentially leading to weight loss.
Managing Weight Changes After Stopping Emgality
If you experience weight changes after stopping Emgality, several strategies can help manage your weight effectively:
- Consult with Your Doctor: Discuss your weight changes with your doctor to rule out any underlying medical conditions or medication interactions.
- Adopt a Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, lean protein, and whole grains. Limit processed foods, sugary drinks, and unhealthy fats.
- Engage in Regular Exercise: Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, along with strength training exercises.
- Limit Portion Sizes: Be mindful of portion sizes to avoid overeating. Use smaller plates and bowls, and measure your food if necessary.
- Stay Hydrated: Drink plenty of water throughout the day to help you feel full and support your metabolism.
- Get Enough Sleep: Aim for 7-8 hours of quality sleep per night to regulate your appetite and metabolism.
- Reduce Stress: Practice stress-reducing techniques such as yoga, meditation, or spending time in nature.
- Consider Professional Guidance: Consult with a registered dietitian or certified personal trainer for personalized advice and support.
Medications and Weight Gain: A Broader Perspective
It's important to note that many medications can cause weight gain as a side effect. These include:
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs).
- Antipsychotics: Risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel).
- Antihistamines: Cetirizine, fexofenadine, and desloratadine.
- Birth Control: Some oral contraceptives.
- Corticosteroids: Prednisone (Deltasone), methylprednisolone (Medrol), and budesonide (Pulmicort).
- Diabetes Medications: Insulin and sulfonylureas.
- Antiseizure Medications: Carbamazepine.
- Beta-Blockers: Medications that lower stress on the heart and blood vessels.
Understanding that weight gain can be a side effect of certain medications is the first step in addressing it. Strategies to manage medication-related weight gain include switching medications, lowering the dosage, limiting portion sizes, exercising, eating more protein, consulting a dietitian, avoiding alcohol, getting enough sleep, drinking more water, and reducing salt intake.
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The Role of GLP-1 Receptor Agonists in Weight Management
The information provided includes details about orforglipron, an oral glucagon-like peptide-1 (GLP-1) receptor agonist, and its effectiveness in promoting weight loss. While not directly related to Emgality, this information highlights the growing interest in GLP-1 receptor agonists for weight management.
Orforglipron: A Promising Oral GLP-1 Receptor Agonist
A phase III clinical trial of orforglipron demonstrated substantial weight loss in individuals with obesity who did not have type 2 diabetes. The study found that patients receiving orforglipron, in conjunction with a healthy diet and physical activity, experienced significantly greater reductions in body weight compared to placebo. Higher doses of orforglipron resulted in greater weight loss, with some patients achieving an average weight loss of 11.2% over 72 weeks.
Considerations for GLP-1 Receptor Agonist Use
While GLP-1 receptor agonists like orforglipron show promise for weight management, it's essential to consider potential side effects, such as gastrointestinal symptoms. Additionally, the long-term effects and optimal use of these medications are still being studied.
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