Complete Medication Contraindications for AJOVY (Fremanezumab)
AJOVY has only one absolute contraindication: serious hypersensitivity to fremanezumab-vfrm or any of its excipients, including anaphylaxis and angioedema. 1
Absolute Contraindication
- Serious hypersensitivity reactions to fremanezumab-vfrm or any excipient components, specifically including:
If hypersensitivity occurs during treatment, discontinue AJOVY immediately and institute appropriate therapy. 1
Important Clinical Context: What is NOT Contraindicated
Unlike many migraine preventive medications, fremanezumab has a remarkably limited contraindication profile. The following conditions are NOT contraindications for AJOVY, which distinguishes it from other migraine treatments:
Cardiovascular Conditions (Not Contraindicated)
- Ischemic heart disease - fremanezumab does not cause vasoconstriction and can be safely used 2
- Stroke history - no cardiovascular contraindications exist 2
- Peripheral vascular disease - safe for use 2
- Uncontrolled hypertension - unlike erenumab, fremanezumab has not been associated with development or worsening of hypertension in post-marketing studies 2
- Coronary heart disease - while one guideline suggests caution, this is not an FDA-labeled contraindication 3
Other Conditions (Not Contraindicated)
- Inflammatory bowel disease - mentioned as a caution in one guideline but not an FDA contraindication 3
- Chronic obstructive pulmonary disease - similarly noted for caution but not contraindicated 3
- Impaired wound healing - guideline caution only, not an FDA contraindication 3
- Subarachnoid hemorrhage history - guideline caution only 3
Special Populations
- Pregnancy and lactation - no specific contraindications listed in FDA labeling, though comprehensive pregnancy data is limited 4
- Renal impairment - no contraindications or dose adjustments required (unlike many other migraine preventives) 1
- Hepatic impairment - no contraindications listed 1
Key Clinical Pitfall to Avoid
Do not confuse the extensive contraindication lists of other migraine preventive medications with fremanezumab's profile. For comparison:
- Topiramate is contraindicated in nephrolithiasis, pregnancy, lactation, and glaucoma 3
- Beta-blockers are contraindicated in asthma, cardiac failure, and atrioventricular block 3
- Sodium valproate is absolutely contraindicated in women of childbearing potential 3
Fremanezumab's single contraindication (serious hypersensitivity) makes it one of the safest options from a contraindication standpoint among all migraine preventive therapies. 1