Ajovy (Fremanezumab) Injection for Migraine - Dose, Side effects

Ajovy (Fremanezumab) is a human monoclonal antibody that specifically targets that peptide associated to the calcitonin gene. It can be administered subQ as an injectable formulation.

Ajovy (Fremanezumab) Uses:

  • Migraine prophylaxis:

    • It is approved for the adult population's prophylaxis of migraines.

Other drugs for the prophylaxis of migraine that acts on the same receptors include:

Ajovy (Fremanezumab) Dose in Adults

Ajovy (Fremanezumab) Dose in the prophylaxis of Migraine:

  • 225 mg as a subQ injection once a month or
  • 675 mg every three monthly.
  • When changing the dosage options, the new regimen's first dose should be taken on the following planned administration date.

Ajovy (Fremanezumab) use in children:

Not recommended for use in children under the age of 18.

Ajovy (Fremanezumab) Pregnancy Risk Category: B1

  • Studies on animal reproduction have not revealed any adverse effects.
  • Information on human pregnancies, however, is not available.

Fremanezumab can be used during breastfeeding

  • It is unknown if the drug will be excreted into breastmilk.
  • When treating the mother, the manufacturer suggests that you weigh the risks and benefits to the infant as well as the potential for therapy.

Ajovy (Fremanezumab) Dose in Kidney Disease:

  • The manufacturer has not recommended any dose adjustments in patients with kidney disease.
  • However, renal impairment does not affect the pharmacokinetics of the drug.

Ajovy (Fremanezumab) Dose in Liver disease:

  • The manufacturer has not recommended any adjustments in the dose in patients with liver disease.
  • However, the liver disease does not alter the pharmacokinetics of the drug.

Side Effects of Ajovy (Fremanezumab):

  • Local:

    • Injection site reaction
  • Immunologic:

    • Antibody development
  • Hypersensitivity:

    • Hypersensitivity reaction

Contraindications to Ajovy (Fremanezumab):

Severe allergic reactions to fremanezumab and any component of the formulation

Warnings and precautions

  • Hypersensitivity

    • Allergies of various severity can occur, including urticaria and rash, pruritus and drug hypersensitivity reactions.
    • Most reactions are mild to moderate in intensity and can occur within an hour to one month after the drug is administered.
    • Allergy patients should stop taking the drug and seek treatment.
  • Cardiovascular disease

    • Patients with heart disease should use it with caution.
    • Patients with severe cardiovascular disease, ischemia and thromboembolic episodes, transient ischemic attack, deep vein embolism, and significant cardiovascular disease have not been treated with the drug.

Monitoring parameters:

  • Monitor the response by calculating the number of monthly migraine days. 

How to administer Ajovy (Fremanezumab)?

  • This product is only for subQ usage. It should not be exposed to direct sunlight. 
  • Prefilled syringes should be left at room temperature for approximately 30 minutes before being administered.
  • It shouldn't be warmed in hot water or microwaves, and it shouldn't be stirred.
  • You should apply it to the abdomen, thighs, and upper arms, keeping out inflamed or indurated areas.
  • Three injections of 675 mg should be given at three different sites.
  • Each injection should consist of three consecutive injections each of 225 mg. Rotate the injection site for multiple injections. 

Mechanism of action of Ajovy (Fremanezumab):

Fremanezumab, a monoclonal human antibody, acts as an antagonist to the calcitonin gene related peptide (CGRP).

Metabolism:

  • Like other immunoglobulins, it is degraded into small peptides and amino acids by proteolytic degradation.

Half-life elimination:

  • It has a half-life elimination of about 31 days.

Time to peak:

  • 5 to 7 days

International Brands of Fremanezumab:

  • Ajovy

Fremanezumab Brand Names in Pakistan:

No Brands Available in Pakistan.