Ajovy alternatives: What can I take instead of Ajovy?

In this article:

• Ajovy alternatives
• Aimovig
• Emgality
• Vyepti
• Nurtec ODT
• Inderal LA
• OTC options
• Natural alternatives
• How to switch
• Choosing the right treatment

In this article

• Ajovy alternatives
• Aimovig
• Emgality
• Vyepti
• Nurtec ODT
• Inderal LA
• OTC options
• Natural alternatives
• How to switch
• Choosing the right treatment

Migraines are a common type of headache that affects about 39 million people in the United States. The condition can affect anyone, including men, women, and children. While there is no cure for migraines, several treatments are available that can help relieve migraine headache symptoms. 

Ajovy (fremanezumab) is a brand-name prescription drug used for the preventive treatment of migraines. It is a monoclonal antibody that belongs to the drug class known as calcitonin gene-related peptide (CGRP) antagonists. Ajovy is an injectable medication that is administered either once a month or once every three months. While it is an effective medication for many, it can cause certain side effects and worsen some existing medical conditions, such as high blood pressure. Ajovy is also quite costly. Therefore, it may not be right for everyone. Fortunately, there are several Ajovy alternatives. 

What can I take instead of Ajovy?

Other treatments are available to treat migraines that do not improve with Ajovy. These include other CGRP antagonists, pain relievers, triptans, ergotamines, and certain beta blockers. Alternatives to Ajovy may be more suitable for some individuals due to their different uses, administration, dosages, side effect profiles, and cost.

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the “Savings options” link to see the latest drug prices.

Top 5 Ajovy alternatives

The following are some of the most common alternatives to Ajovy.

1. Aimovig

Aimovig (erenumab) is another brand-name injectable medication used to prevent migraines. Like Ajovy, Aimovig belongs to the drug class known as CGRP antagonists, and both medications are monoclonal antibodies. However, Aimovig is injected under the skin once a month, while Ajovy is injected either once a month or once every three months. Both medications can cause injection site reactions, such as pain, redness, or itching, but some people also experience constipation and muscle spasms with Aimovig. 

2. Emgality

Emgality is also a brand-name injectable medication used as a preventive migraine treatment. However, it is also prescribed to treat episodic cluster headaches. Emgality belongs to the CGRP antagonist drug class. For the prevention of migraines, it is injected under the skin once a month, but healthcare providers usually prescribe an initial loading dose—a dose that’s higher than the usual maintenance dose—to help the drug start working quickly. Like Ajovy, Emgality is only available as a brand-name medication, and there are no generic versions available. 

3. Vyepti

Vyepti is another commonly used CGRP antagonist for migraine prevention in adults. While it is a brand-name injectable drug like Ajovy, Vyepti is administered through intravenous infusion only, whereas Ajovy can be self-administered subcutaneously (under the skin). This means Vyepti will be given by a healthcare provider in a healthcare setting. It is also given once every three months. The most common side effects of Vyepti include a stuffy nose, scratchy throat, and allergic reactions. 

4. Nurtec ODT

Another popular CGRP antagonist is Nurtec ODT. Unlike Ajovy, Nurtec ODT is taken orally and comes as an orally disintegrating tablet that should be placed on or under the tongue for disintegration. Nurtec ODT can be used for both episodic migraine prevention and sudden migraine attacks. For migraine prevention, the recommended dosage is 75 mg once every other day. Nurtec ODT commonly causes nausea, abdominal pain, and indigestion. 

5. Inderal LA (propranolol)

Inderal LA is a beta blocker that is FDA-approved to treat a variety of conditions, including hypertension (high blood pressure), angina (chest pain), hypertrophic subaortic stenosis (a condition where the heart muscle is abnormally thick), and migraine prevention. It is thought to work for migraine prevention by blocking certain receptors in blood vessels in the brain. Inderal LA is available as extended-release capsules, and the recommended dosage is 80-240 mg orally once daily. 

Over-the-counter migraine medication

Another treatment option for migraines is over-the-counter (OTC) medications. For some, OTC options are often more accessible and affordable than prescription treatments. In fact, research shows that by the time a patient sees a headache specialist, they have tried an average of more than two OTC medications for their migraine. However, they still have their potential risks, so it’s best to consult a healthcare provider before starting any new OTC migraine medications. 

Common OTC migraine treatments include: 

• Aleve (naproxen sodium)
• Advil (ibuprofen)
• Excedrin Migraine (aspirin/acetaminophen/caffeine)
• Excedrin Tension Headache (acetaminophen/caffeine)
• Tylenol Extra Strength (acetaminophen)
• Sudafed (pseudoephedrine)

Natural alternatives to Ajovy

According to the American Migraine Foundation and American Headache Society, certain foods and supplements are believed to help manage migraine symptoms. Supplements such as omega-3 fatty acids, coenzyme Q10, magnesium, vitamin B, and vitamin D have some evidence supporting their use for migraine prevention. Medicinal plants, such as butterbur and feverfew, are also used for migraine prevention. However, the evidence supporting their use is mixed and may have dangerous side effects. 

The American Migraine Foundation also recommends certain lifestyle modifications that may help with migraines, including:

• Practicing good sleep habits
• Engaging in light-impact exercises
• Staying hydrated
• Keeping the lights dim
• Avoiding migraine triggers

There is also evidence that certain foods and drinks can help prevent or trigger migraines. 

How to switch to an Ajovy alternative

If you’re considering an Ajovy alternative, speak to your healthcare provider. Ajovy’s prescribing label doesn’t note any withdrawal effects when stopping the medication, and healthcare providers typically do not have you taper off the drug. Nevertheless, switching medications should only be done with the approval of and guidance of a healthcare provider. They can discuss which alternative is safe for you. It is also important to consider cost when switching medications. Many migraine medications only come as brand-name options and can be costly. Therefore, you may also want to contact your insurance provider to understand the financial implications of switching medications. 

Lastly, it is important that you don’t stop taking Ajovy until you consult with your healthcare provider. If you and your provider agree on switching to an Ajovy alternative, they will provide medical advice on how to do so.

Choosing the right path for migraine treatment

Migraines can be a debilitating illness for those who experience them. Fortunately, there are a variety of migraine treatments available, including several newer migraine medications. Whether Ajovy isn’t working for you, you’re having bothersome side effects from the drug, or you are struggling to afford the medication, talk to your healthcare provider. They can discuss alternatives to Ajovy, such as Aimovig, Emgality, Inderal LA, or Nurtec ODT. Based on your medical history and other medications, they can help you choose the alternative that is right for you.