Throbbing headache, nausea, and sensitivity to light—another day disrupted by a migraine. For those with chronic migraines, these debilitating attacks interfere with work, relationships, and daily routines, making even simple tasks feel impossible.
Despite various treatment options, many people continue to struggle with frequent migraines and limited relief. Managing the condition can be frustrating, leading patients to explore different options for migraine prevention.
Fremanezumab is a preventive treatment that may help individuals with chronic migraines. Targeting a key pathway involved in migraine development may help reduce the frequency and severity of attacks in some individuals.
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What is Fremanezumab?
Fremanezumab is a preventive treatment for chronic migraines that belongs to a class of medications called monoclonal antibodies (mAbs).
It works by blocking Calcitonin Gene-Related Peptide (CGRP), a protein involved in migraine attacks.
Unlike medications that provide relief during an episode, fremanezumab is designed to help reduce the frequency of migraines over time as part of a preventive approach.
How Does Fremanezumab Work?
During a migraine, elevated CGRP levels cause blood vessel changes and activate pain pathways in the brain, contributing to the intensity of the attack.
While certain migraine relief medications, such as triptans, temporarily block CGRP to ease symptoms, fremanezumab is designed to reduce CGRP activity over time.
By modulating CGRP activity, fremanezumab may help reduce the number and severity of migraine attacks for some individuals.
Who is Fremanezumab For?
Fremanezumab is prescribed for individuals diagnosed with chronic migraines, which means experiencing more than 15 headache days per month, with at least eight days showing migraine symptoms, for at least three months.
It is also considered for patients who:
- Have not responded to at least three different preventive migraine treatments.
- Have ruled out overuse of pain relief medications as a cause of their headaches.
- Have explored botulinum toxin (Botox) therapy but did not find it effective or preferred an alternative option.
A neurologist will assess each patient’s medical history, previous treatments, and migraine patterns to determine if fremanezumab is an appropriate option.
Administration and Dosage
Fremanezumab is a prescription-only injectable solution that may help reduce migraine frequency in some individuals. It is available in prefilled syringes or autoinjectors.
Method of Administration
This medication is given as a subcutaneous injection (under the skin) and can be administered by a healthcare provider or self-injected at home after proper training.
It is typically injected into the stomach, thighs, or upper arm. To minimize skin irritation, injection sites should be rotated and avoided if they are bruised, red, swollen, or hardened.
Injection Guidelines
Before use, the prefilled syringe or autoinjector should be examined to ensure the liquid is clear and colorless to slightly yellow.
If the solution appears cloudy, discolored, or contains particles, it should not be used.
The medication should be allowed to reach room temperature for at least 30 minutes before injection but should not be heated using external sources.
The needle cap should remain on until the injection is ready, and each syringe or autoinjector is for single use only. Any remaining medication should be discarded after use.
Recommended Dosage Schedules
The dosage of fremanezumab depends on the prescribed treatment plan, with two standard options:
- 225 mg injected once per month
- 675 mg injected once every three months
Missed Dose and Storage Instructions
If a dose is missed, it should be taken as soon as possible.
However, if the next scheduled dose is near, the missed dose should be skipped, and the regular dosing schedule should continue.
Patients should follow a consistent injection schedule each month based on their last dose.
Fremanezumab must be stored in the refrigerator and should never be frozen.
If necessary, it can be kept at room temperature for up to 24 hours, but any unused medication left out beyond this period should be discarded.
Used needles must be disposed of in a designated sharps container to ensure safe and proper disposal.
Side Effects and Drug Interactions
Fremanezumab has been reported to be well tolerated in clinical studies, but like all medications, it may cause side effects. Some are mild and temporary, while others may require immediate medical attention.
Common side effects (notify your doctor if they persist or become uncomfortable):
- Redness, pain, or irritation at the injection site
Serious side effects (seek medical attention immediately):
- Signs of an allergic reaction, such as skin rash, itching, or hives
- Swelling of the face, lips, or tongue
While these are the known side effects, individuals may experience different reactions. Patients should consult their healthcare provider about any new or unusual symptoms.
Drug Interactions
Fremanezumab is not known to interact with other medications.
However, it is important to inform your healthcare provider about all prescription and over-the-counter medications, supplements, and herbal products you are taking.
Additionally, discuss any use of alcohol or tobacco, as these may affect overall health and treatment outcomes.
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Key Takeaways
- Fremanezumab is a targeted preventive treatment that modulates CGRP, a protein involved in migraine attacks, and may help reduce both the frequency and severity of migraines over time.
- It is administered as a subcutaneous injection, with dosing options of 225 mg once a month or 675 mg every three months, allowing for a treatment plan based on individual needs.
- The medication is generally well tolerated, with mild injection site reactions being the most common side effect, while serious allergic reactions are rare but require immediate medical attention.
- A healthcare provider should be consulted to determine if fremanezumab is appropriate, assess potential risks, and review other medications or lifestyle factors that could impact treatment effectiveness.
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