From the Guidelines
Emgality should be administered as a monthly subcutaneous injection, starting with a loading dose of 240 mg, followed by 120 mg once monthly thereafter. This dosing schedule is based on the mechanism of action of galcanezumab, which binds to calcitonin gene-related peptide (CGRP), a protein involved in migraine pain transmission, thereby preventing it from attaching to its receptors 1. The standard administration route is via prefilled pens or syringes, injecting into the abdomen, thigh, or back of the upper arm.
- Key points to consider when administering Emgality include:
- Maintaining a consistent monthly schedule, ideally administering each dose on the same date each month
- If a dose is missed, it should be administered as soon as possible, then the next dose should be given one month from that date
- Patients or caregivers can administer the medication at home, making it a convenient option for migraine prevention
- Emgality has been shown to reduce the frequency of migraine attacks over time, with many patients experiencing benefits within the first month of treatment, as noted in the context of calcitonin gene-related peptide inhibitors such as Erenumab-aooe (Aimovig), Fremanezumab (Ajovy), and Galcanezumab (Emgality) 1.
From the FDA Drug Label
2.1 Recommended Dosing for Migraine The recommended dosage of EMGALITY is 240 mg (two consecutive subcutaneous injections of 120 mg each) once as a loading dose, followed by monthly doses of 120 mg injected subcutaneously. If a dose of EMGALITY is missed, administer as soon as possible. Thereafter, EMGALITY can be scheduled monthly from the date of the last dose.
2.2 Recommended Dosing for Episodic Cluster Headache The recommended dosage of EMGALITY is 300 mg (three consecutive subcutaneous injections of 100 mg each) at the onset of the cluster period, and then monthly until the end of the cluster period. If a dose of EMGALITY is missed during a cluster period, administer as soon as possible Thereafter, EMGALITY can be scheduled monthly from the date of the last dose until the end of the cluster period.
The EMGALITY schedule is as follows:
- For migraine: 240 mg loading dose, followed by 120 mg monthly doses.
- For episodic cluster headache: 300 mg at the onset of the cluster period, followed by monthly doses until the end of the cluster period. If a dose is missed, it should be administered as soon as possible, and then the schedule can be continued monthly from the date of the last dose 2.
From the Research
Emgality Schedule
The Emgality schedule is related to the administration of galcanezumab, a monoclonal antibody targeting calcitonin gene-related peptide (CGRP) for the prevention of migraines.
- The recommended dosage of galcanezumab is 120 mg per month, with a 240 mg loading dose administered as two 120 mg injections 3.
- The treatment is given in a monthly injection for the prevention of migraines 3.
- Studies have shown that galcanezumab exhibits consistent efficacy throughout the dosing interval among patients with episodic and chronic migraine 4.
- The consistency of the treatment effect of galcanezumab throughout the dosing interval is examined in patients with episodic and chronic migraine, with results showing that weekly migraine headache day reduction was significantly greater with galcanezumab relative to placebo every week 4.
Administration and Efficacy
- Galcanezumab is administered via subcutaneous injection, with a loading dose of 240 mg followed by monthly maintenance doses of 120 mg 5, 6.
- The efficacy of galcanezumab in reducing monthly migraine headache days has been demonstrated in several clinical trials, including the CONQUER and REGAIN studies 5, 6.
- Galcanezumab has been shown to be effective in reducing monthly migraine headache days, with a significant reduction in migraine frequency and improvement in functional capacity 5, 6, 3, 7.
Safety and Tolerability
- Galcanezumab has been shown to be well-tolerated and safe, with a low incidence of adverse events 5, 6, 3, 7.
- The most common adverse events reported in clinical trials were injection site reactions, such as pain, redness, and swelling 5, 6.
- Galcanezumab has been shown to be effective and safe for the treatment of patients affected by chronic migraine and medication overuse headache 7.