What is Galcanezumab: Uses, Dosage, Side Effects and More

Galcanezumab is a prescription medication specifically designed to prevent migraine headaches in adults. It's a targeted treatment that works by blocking a protein called CGRP (calcitonin gene-related peptide) that plays a key role in triggering migraines. This monthly injection offers hope for people who struggle with frequent, debilitating headaches that interfere with their daily lives.

What is Galcanezumab?

Galcanezumab belongs to a newer class of medications called CGRP inhibitors or monoclonal antibodies. Think of it as a highly specific shield that your body uses to block the signals that can trigger migraine attacks. Unlike older migraine medications that were originally developed for other conditions, galcanezumab was created exclusively for migraine prevention.

The medication comes as a pre-filled pen or syringe that you inject under your skin once a month. It's designed for people who experience frequent migraines and need consistent, long-term prevention rather than just treating headaches after they start.

What is Galcanezumab Used For?

Galcanezumab is primarily prescribed to prevent migraine headaches in adults who get them frequently. Your doctor might recommend this medication if you experience four or more migraine days per month and other preventive treatments haven't worked well for you.

The medication is also approved for treating episodic cluster headaches, which are extremely painful headaches that occur in cyclical patterns. These headaches are different from migraines and tend to happen in groups or "clusters" over weeks or months.

Some doctors may prescribe galcanezumab for chronic migraines, where you experience headaches on 15 or more days per month. The goal is to reduce both the frequency and severity of your headaches, giving you more pain-free days to enjoy your life.

How Does Galcanezumab Work?

Galcanezumab works by targeting CGRP, a protein that your body releases during migraine attacks. When CGRP is released, it causes blood vessels in your head to dilate and triggers inflammation and pain signals. This medication acts like a key that fits into the CGRP lock, preventing it from causing these painful changes.

This is considered a moderately strong preventive medication, meaning it's quite effective but typically reserved for people who haven't responded well to first-line treatments. Unlike some migraine medications that affect your entire nervous system, galcanezumab works very specifically on the migraine pathway.

The effects build up over time, so you might not notice the full benefits immediately. Most people start seeing improvements within the first month, but it can take up to three months to experience the medication's full preventive effects.

How Should I Take Galcanezumab?

Galcanezumab is given as a subcutaneous injection, which means you inject it into the fatty tissue just under your skin. Your healthcare provider will teach you how to give yourself these injections safely at home. The most common injection sites are your thigh, upper arm, or stomach area.

You'll typically start with a loading dose of 240 mg (two 120 mg injections) on your first day, followed by 120 mg (one injection) once a month. Take the medication out of the refrigerator about 30 minutes before injecting to let it reach room temperature, which makes the injection more comfortable.

You can take galcanezumab with or without food since it's injected rather than taken by mouth. Try to inject it on the same day each month to maintain consistent levels in your system. If you're uncomfortable with self-injection, your doctor's office can administer it for you.

How Long Should I Take Galcanezumab For?

Most people take galcanezumab for at least three to six months to properly evaluate its effectiveness. Your doctor will likely recommend giving it a fair trial period since it can take time to see the full benefits. Some people notice improvements within the first month, while others may need up to three months.

If galcanezumab is working well for you, your doctor might recommend continuing it long-term. Many people take it for a year or more to maintain their improved quality of life. The medication appears to remain effective with continued use, and there's no evidence that it loses its preventive effects over time.

Your healthcare provider will regularly check in with you to assess how well the medication is working and whether you're experiencing any side effects. They'll help you decide whether to continue, adjust the timing, or explore other options based on your individual response.

What Are the Side Effects of Galcanezumab?

Like all medications, galcanezumab can cause side effects, though many people tolerate it quite well. The most common side effects are generally mild and tend to improve as your body adjusts to the medication.

Here are the most frequently reported side effects you might experience:

• Injection site reactions like redness, swelling, or mild pain
• Upper respiratory tract infections or cold-like symptoms
• Constipation or changes in bowel movements
• Fatigue or feeling more tired than usual
• Dizziness or lightheadedness
• Nausea or stomach discomfort

Most injection site reactions are mild and resolve within a day or two. You can apply a cold compress before injection and a warm compress afterward to minimize discomfort.

While less common, some people may experience more serious side effects that require medical attention:

• Severe allergic reactions with difficulty breathing or swelling of face, lips, or throat
• Severe constipation that doesn't improve with usual remedies
• Persistent or worsening injection site reactions
• Unusual changes in mood or behavior

These serious reactions are rare, but it's important to contact your healthcare provider immediately if you experience any concerning symptoms. Most people find that the benefits of reduced migraines outweigh the mild side effects they might experience.

Who Should Not Take Galcanezumab?

Galcanezumab isn't right for everyone, and your doctor will carefully evaluate whether it's safe for you. People with known allergies to galcanezumab or any of its ingredients should avoid this medication completely.

Your healthcare provider will want to discuss your medical history thoroughly before prescribing galcanezumab, especially if you have:

• A history of severe allergic reactions to other medications
• Active infections or a compromised immune system
• Severe kidney or liver problems
• A history of cardiovascular disease
• Plans to become pregnant or are currently breastfeeding

The medication hasn't been extensively studied in pregnant women, so your doctor will weigh the potential benefits against unknown risks if you're planning to conceive. Similarly, it's not known whether galcanezumab passes into breast milk.

Children and adolescents under 18 shouldn't take galcanezumab since it hasn't been proven safe or effective in younger age groups. Your doctor will consider alternative treatments if you're in this age range.

Galcanezumab Brand Names

Galcanezumab is sold under the brand name Emgality in the United States and many other countries. You might see this name on your prescription label, insurance paperwork, or when discussing the medication with your healthcare team.

Emgality is manufactured by Eli Lilly and Company and comes in pre-filled pens and pre-filled syringes. Both forms contain the same medication and work equally well, though some people find one delivery method more comfortable than the other.

When talking with your pharmacist or insurance company, you can use either the generic name (galcanezumab) or the brand name (Emgality). They'll know exactly what medication you're referring to.

Galcanezumab Alternatives

If galcanezumab isn't the right fit for you, several other migraine prevention options are available. Your doctor can help you explore these alternatives based on your specific situation, medical history, and treatment goals.

Other CGRP inhibitors work similarly to galcanezumab and might be good alternatives:

• Fremanezumab (Ajovy) - another monthly injection option
• Erenumab (Aimovig) - targets a different part of the CGRP pathway
• Eptinezumab (Vyepti) - given by IV infusion every three months

Traditional migraine preventive medications might also be considered, especially if you prefer daily pills over monthly injections. These include certain antidepressants, anti-seizure medications, and beta-blockers that have shown effectiveness in preventing migraines.

Your healthcare provider will consider factors like your other medical conditions, current medications, lifestyle preferences, and insurance coverage when recommending alternatives. The goal is finding the most effective treatment that fits comfortably into your life.

Is Galcanezumab Better Than Sumatriptan?

Galcanezumab and sumatriptan serve different purposes in migraine treatment, so comparing them is a bit like comparing apples and oranges. Galcanezumab is a preventive medication that you take monthly to reduce the frequency of migraines, while sumatriptan is an acute treatment that you take when a migraine starts.

Many people actually use both medications together as part of a comprehensive migraine management plan. You might take galcanezumab monthly to prevent migraines and keep sumatriptan on hand for breakthrough headaches that still occur.

If you're currently using sumatriptan frequently (more than 10 days per month), your doctor might recommend adding galcanezumab to reduce your overall migraine burden. This approach can help you rely less on acute medications and potentially avoid medication overuse headaches.

The "better" choice depends entirely on your migraine pattern, frequency, and how well you respond to each type of treatment. Your healthcare provider can help you determine the most effective combination for your specific situation.