Side Effects of Aimovig (Erenumab)
The most common side effects of Aimovig (erenumab) include injection site reactions, constipation, and hypersensitivity reactions, with constipation potentially leading to serious complications requiring hospitalization in some cases. 1
Common Side Effects
Aimovig's FDA-approved drug label identifies several common adverse reactions:
- Injection site reactions (pain, redness, swelling)
- Constipation (can be severe)
- Hypersensitivity reactions (can occur within hours to more than a week after administration)
- Hypertension (new-onset or worsening of pre-existing high blood pressure)
Serious Side Effects
Constipation with Complications
Constipation is not just a minor inconvenience with Aimovig - it can lead to serious complications:
- Some cases have required hospitalization or surgery
- Watch for severe or constant abdominal pain, vomiting, abdominal swelling, or bloating 1
Allergic Reactions
- Can range from rash to swelling
- May occur within hours to days after injection
- Signs requiring immediate medical attention include:
- Swelling of face, mouth, tongue, or throat
- Breathing difficulties 1
Cardiovascular Effects
- High blood pressure or worsening of existing hypertension
- Regular blood pressure monitoring is advisable
- Although there were theoretical concerns about vasoconstriction with this class of drugs (CGRP receptor antagonists), these concerns have not been confirmed clinically 2
Perioperative Considerations
For patients undergoing surgery, Aimovig can be continued throughout the perioperative period:
- Surgical treatment can be scheduled at any time during the treatment cycle
- Can be administered even on the day of injection 2
- Unlike triptans, which should be held on the day of operation, Aimovig does not have significant drug-drug interactions with common anesthetic agents
Administration and Monitoring
- Subcutaneous injection once monthly
- Available in 70mg and 140mg doses
- Store in refrigerator (36°F to 46°F)
- Can be kept at room temperature for up to 7 days
- Monitor for:
- Signs of allergic reaction
- Constipation
- Blood pressure changes
Special Populations
- Pregnancy: Limited data available; pregnancy registry exists to monitor outcomes in women exposed to Aimovig during pregnancy
- Breastfeeding: Unknown if Aimovig passes into breast milk
Clinical Perspective
In clinical trials, Aimovig demonstrated efficacy in reducing migraine frequency while maintaining a relatively favorable side effect profile compared to many traditional migraine preventives. The most common adverse events were mild to moderate in severity, with few patients discontinuing treatment due to side effects 3.
Unlike many other migraine preventive medications that were originally developed for other conditions (such as antiepileptics, antidepressants, or antihypertensives), Aimovig was specifically developed for migraine prevention, which may contribute to its targeted side effect profile 4.