Aimovig Mechanism of Action (Erenumab) for Migraine

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Aimovig is a drug that is used in the preventive treatment of migraine headaches. It has got a unique mechanism of action.

Aimovig is the brand name of Erenumab that is available as 70 mg/ml monthly subcutaneous injections.

It is primarily indicated to prevent and reduce the severity of migraine headaches in patients who have more than three episodes per month of migraine headaches or in those with a single but very severe headache that lasts more than 24 hours.

See FDA Prescribing Information of Aimovig

Because of the unique mechanism of action of Aimovig, it has got very few side effects. Most side effects are related to the injection site.

How does Aimovig Work in the Prevention of Migraine?

Aimovig or Erenumab is a human monoclonal antibody that targets the binding of calcitonin gene-related peptide (CGRP) and its receptors.

It binds to the CGRPR (calcitonin gene-related peptide Receptors) and inhibits the interaction between the CGRP and CGRPR.

Once the interaction is inhibited, further biochemical processes are also inhibited. Since one of the primary actions of CGRPR activation is vascular dilation, its inhibition results in vasoconstriction of the intracranial vessels.

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When administered on a monthly basis, it causes vasoconstriction and reduces the frequency and severity of migraine episodes.

When does Aimovig start working?

Aimovig (Erenumab) starts working slowly. You should not expect immediate results. For acute migraine attacks, it is not recommended that you require rapid clinical improvement.

After it is administered subcutaneously into the skin, it reaches the maximum plasma concentration in about six days.

Hence the effect of the drug should best be observed after six days of administering it.

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How safe is Aimovig (Erenumab)?

Aimovig is considered a very safe medicine. The three common side effects of the drug observed by patients in clinical trials included:

  • Injection-site reactions:
    • Injection site reactions occurred at the site of the injection. Patients noticed redness, swelling, itching, and pain at the site of the injection.
  • Constipation:
    • Constipation was comparatively more frequent in the actively treated group compared to the placebo.
  • Myalgias and muscle spasms:
    • Patients also reported muscle spasms and myalgias.

These three side effects were more frequent compared to patients in the placebo-treated group.