Ajovy ( fremanezumab-vfrm) is a prescription drug that’s used to prevent migraine episodes in adults. Ajovy comes as a single-use prefilled syringe or pen that you inject under your skin.

Ajovy is used in adults for the preventive treatment of migraine.

Migraine is a condition that can cause many different symptoms. These include severe headache episodes, nausea and vomiting, and trouble speaking clearly.

To learn more about this drug’s use, see “Is Ajovy used for migraine?” on this page.

Ajovy basics

Ajovy is a biologic medication that contains the active ingredient fremanezumab-vfrm. A biologic is made from parts of living organisms. Ajovy is only available as a brand-name drug. It isn’t available in a biosimilar form.

Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs. In other words, the biologic drug fremanezumab-vfrm is currently only available as the brand-name medication Ajovy.

Ajovy belongs to a group of drugs called calcitonin gene-related peptide (CGRP) antagonists.

Ajovy comes as a liquid solution inside single-use, prefilled syringes and auto-injector pens. You’ll give yourself Ajovy injections.

Read on to learn about Ajovy’s side effects, uses, and more.

Like most drugs, Ajovy may cause mild or serious side effects. Some of the more common side effects that Ajovy may cause are described below. These are not all the possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Ajovy. They can also suggest ways to help reduce side effects.

Mild side effects

Injection site reactions are the most commonly reported mild side effect of Ajovy. For more information about injection site reactions, see the “Side effect focus” section.

To learn about other mild side effects, talk with your doctor or pharmacist, or read Ajovy’s prescribing information.

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ajovy can occur, but they aren’t common. If you have serious side effects from Ajovy, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Allergic reaction is the most commonly reported serious side effect of Ajovy. For more information on allergic reaction, see the “Side effect focus” section.

Side effect focus

Learn more about some of the side effects Ajovy may cause.

Injection site reactions

You may have injection site reactions while you’re taking Ajovy. This was the most common side effect in studies of the drug.

You may have any of the following around the area where you inject Ajovy:

  • pain
  • redness or discoloration
  • itchiness
  • hardened or thickened skin

What might help

Below are a couple of ways you may be able to reduce your risk of injection site reactions with Ajovy:

  • Inject each dose into a new area of skin: You can inject Ajovy into your thighs, upper arms, or belly. If you take multiple injections for each dose, you can inject the drug into the same area of your body. But you should give each injection at least one finger width away from the spot you injected the dose before it.
  • Don’t inject into an area that’s tender, red, discolored, or bruised: Avoid injecting Ajovy into any injured area of your body until it has completely healed.

If you have bothersome injection site reactions while taking Ajovy, talk with your doctor. They can suggest ways to help ease this side effect.

Allergic reaction

Some people may have an allergic reaction to Ajovy. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. Symptoms can also include swelling of your tongue, mouth, or throat, which can cause difficulty breathing.

Call your doctor right away if you have an allergic reaction to Ajovy. But if you think you’re having a medical emergency, call 911 or your local emergency number.

If you have migraine, your doctor may prescribe Ajovy.

Ajovy’s indication is to help prevent migraine in adults. (A drug’s indication is the condition it’s approved to treat.)

Migraine is a condition that may cause a variety of symptoms. Severe headache is the most common symptom, but others include:

Ajovy works by blocking a protein in your body called calcitonin gene-related peptide (CGRP). CGRP is thought to play a role in causing migraine. By blocking CGRP, Ajovy helps prevent migraine episodes.

To learn more about how Ajovy helps prevent migraine, talk with your doctor.

Your doctor will recommend the dosage of Ajovy that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Forms and strength

Ajovy comes as a liquid solution inside single-use, prefilled syringes and auto-injector pens. You’ll give yourself the medication as an injection under your skin.

It comes in one strength of 225 milligrams (mg) in 1.5 milliliters (mL) of liquid solution.

Recommended dosages

Ajovy has two recommended dosage options:

  • one 225 mg Ajovy injection once every month, on the same day each month
  • 675 mg (three 225 mg Ajovy injections given one after the other) once every 3 months, on the same day every third month

Your doctor will help you decide on the best dosage of Ajovy for your lifestyle.

Questions about Ajovy’s dosage

Below is a list of common questions related to Ajovy’s dosage.

  • What if I miss a dose of Ajovy? Inject your missed dose of Ajovy as soon as you remember. You’ll take your next dose based on the date you injected the missed dose. For example, if you take Ajovy every month, you’ll inject your next dose one month from the date you took your missed dose. If you take Ajovy every 3 months, you’ll inject your next dose 3 months from the date you took your missed dose. If you have questions about a missed dose or your new dosing schedule, talk with your doctor or pharmacist.
  • Will I need to take Ajovy long term? Yes, most likely. If you and your doctor decide that Ajovy is safe and effective for you, you’ll probably take the drug long term.
  • How long does Ajovy take to work? Ajovy starts working right away to help prevent migraine. But it may take several doses before you start having fewer migraine episodes.
  • Should I take Ajovy doses with food? You can inject Ajovy with or without having food in your stomach.

Your doctor will explain how you should take Ajovy. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

You’ll inject Ajovy under the skin of your thighs, upper arms, or belly.

You’ll either take one injection once each month, or three injections at the same time once every 3 months. If you’re taking three injections at once, you can inject the drug into the same area of your body each time. But try to give each injection at least one finger width away from the spot you injected the dose before it.

Your doctor will show you how to give yourself Ajovy injections. You can also watch a video with step-by-step instructions for using the syringe and auto-injector on the manufacturer’s site. Or, you can read the instructions in Ajovy’s prescribing information.

Questions for your doctor

You may have questions about Ajovy and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Ajovy affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Whether you have health insurance or not, cost may be a factor when you’re considering Ajovy. What you’ll pay for Ajovy may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for Ajovy when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A savings program through the drug manufacturer may also be available.

Learn more about saving on your prescriptions.

You may want to know how Ajovy compares with alternatives, such as Aimovig. Both Ajovy and Aimovig are prescribed to help prevent migraine in adults.

To see a side-by-side comparison of these drugs, check out the section called “Ajovy vs. Aimovig” in this Aimovig overview article. And be sure to talk with your doctor about which drug is right for you.

Both Ajovy and Emgality are prescribed to prevent migraine in adults. Emgality is also prescribed to treat certain cluster headaches.

To learn more about the similarities and differences between Ajovy and Emgality, see this Emgality vs. Ajovy comparison article. Check with your doctor to find out which of these medications is best for your condition.

Find answers to some common questions about Ajovy.

How does Ajovy work?

Ajovy is prescribed to help prevent migraine. Migraine is a condition that can cause many different symptoms, including a severe headache.

Ajovy’s mechanism of action (how it works in your body) is to block a protein called calcitonin gene-related peptide (CGRP). CGRP is thought to play a role in causing migraine.

A high level of CGRP in your brain can cause the blood vessels in your head to become swollen. This swelling can lead to migraine symptoms such as severe pain. By blocking CGRP, Ajovy helps prevent migraine.

To learn more about how Ajovy works, talk with your doctor or pharmacist.

Can I read people’s reviews about Ajovy?

Yes. Stories from people who’ve taken Ajovy are available on the drug manufacturer’s website.

Keep in mind that this drug may affect people differently. So be sure to talk with your doctor about what you can expect with Ajovy treatment.

What’s the efficacy of Ajovy?

Studies have found that Ajovy is effective at preventing migraine in adults.

In fact, the American Headache Society recommends Ajovy as an option for migraine prevention.

To find out how Ajovy performed in studies, you can read the drug’s prescribing information. To learn more about the drug’s effectiveness, talk with your doctor or pharmacist.

When considering Ajovy treatment, there are a few important things to discuss with your doctor. These include:

  • your overall health
  • all medications you take
  • all medical conditions you have

These considerations and others are discussed in more detail below.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before starting Ajovy, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Ajovy.

Interactions with drugs or supplements

Ajovy isn’t known to interact with any other drugs or supplements, but this doesn’t mean interactions can’t happen. Your doctor or pharmacist can tell you more about possible interactions that may occur with this drug.

Warnings

Ajovy may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Ajovy. Factors to consider include:

  • Allergic reaction: If you’ve had an allergic reaction to Ajovy or any of its ingredients, your doctor will likely not prescribe Ajovy. Ask your doctor what other medications are better options for you.

Ajovy and alcohol

There aren’t any known safety issues with drinking alcohol while taking Ajovy. But drinking alcohol can trigger migraine in some people. And Ajovy is prescribed to help prevent migraine episodes.

If you know alcohol is a migraine trigger for you, you’ll likely want to avoid it while taking Ajovy.

If you drink alcohol, ask your doctor about the amount that’s safe during Ajovy treatment.

Pregnancy and breastfeeding

It’s not known if Ajovy is safe to take while pregnant or breastfeeding.

If you’re breastfeeding, pregnant, or planning either, it’s best to talk with your doctor. They can recommend if it’s safe to take Ajovy during these times.

If you do take Ajovy during pregnancy, consider enrolling in a pregnancy registry. Pregnancy registries collect information about the effects that happen when a drug is used during pregnancy. This information helps researchers understand any risks of taking the drug while pregnant.

To enroll in the Teva Migraine Pregnancy Registry, visit the registry’s site. You can also call 833-927-2605, or talk with your doctor.

Don’t take more Ajovy than your doctor prescribes. Injecting more than this can lead to serious side effects.

What to do in case you inject too much Ajovy

Call your doctor if you think you’ve injected too much Ajovy. You can also call 800-222-1222 to reach America’s Poison Centers or use their online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

You may want to ask your doctor about other options for migraine prevention or choices for migraine treatment. Below are a couple of articles on these topics that may be helpful for you:

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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