CGRP Medications

What Is CGRP?

Calcitonin gene-related peptide (CGRP) is a protein that plays a key role in migraine. During migraine attacks, CGRP is released and causes blood vessel dilation and inflammation. Blocking CGRP can prevent and treat migraines.¹

Types of CGRP Medications

Monoclonal Antibodies (Prevention)²

• Erenumab (Aimovig) - Monthly injection
• Fremanezumab (Ajovy) - Monthly or quarterly
• Galcanezumab (Emgality) - Monthly injection
• Eptinezumab (Vyepti) - IV infusion quarterly

Gepants (Acute and Prevention)

• Ubrogepant (Ubrelvy) - Acute treatment
• Rimegepant (Nurtec) - Acute and prevention
• Atogepant (Qulipta) - Prevention

Benefits³

• Designed specifically for migraine
• Good efficacy in clinical trials
• Fewer side effects than many older preventives
• No cardiovascular contraindications
• Option for patients who failed other treatments

Side Effects

Monoclonal Antibodies

• Injection site reactions
• Constipation (most common)
• Generally well tolerated

Gepants

• Nausea
• Drowsiness
• Generally mild

Who May Benefit

• 4+ migraine days per month
• Failed or can't tolerate other preventives
• Contraindications to other options
• Chronic migraine

References

1. Edvinsson L, Haanes KA, Warfvinge K, Krause DN. CGRP as the target of new migraine therapies. Nat Rev Neurol. 2018;14(6):338-350.
2. Silberstein SD, Holland S. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention. Neurology. 2012;78(17):1337-1345.
3. Dodick DW, Silberstein SD, Bigal ME, et al. Effect of fremanezumab compared with placebo for prevention of episodic migraine. JAMA. 2018;319(19):1999-2008.