Erenumab
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Trade Name
Aimovig (primary brand name); generic erenumab-aooe
Classification
Calcitonin Gene-Related Peptide (CGRP) receptor antagonist; monoclonal antibody, migraine prophylactic
Dosage/Route
- * Dosage: Prefilled autoinjector or syringe: 70 mg/mL, 140 mg/mL
- * Route: Subcutaneous (SC) injection
Usual Dosage
70 mg or 140 mg SC once monthly; choice depends on patient response and provider preference. Some may start at 70 mg and titrate to 140 mg if needed
Mechanism of Action
Binds to and blocks the CGRP receptor, inhibiting CGRP activity—a protein linked to vasodilation and inflammation in migraines. This prevents migraine initiation by reducing neurogenic inflammation and pain signaling
Side Effects & Adverse Effects
- * Side Effects: Injection site reactions (pain, redness), constipation, muscle spasms
- * Adverse Effects:
- – Severe constipation (may require hospitalization)
- – Hypersensitivity (rash, angioedema, anaphylaxis)
- – Hypertension (new or worsening, post-marketing reports)
- – Long-term: theoretical risk of cardiovascular effects (unproven)
Nursing Management (Implications & Teachings)
- * Implications:
- – Assess injection site for reactions; rotate sites (thigh, abdomen, upper arm)
- – Monitor for constipation (esp. with 140 mg) and BP changes
- – Ensure latex allergy screening (needle shield contains rubber)
- – Store in refrigerator; allow 30 min to reach room temp before use
- * Teachings:
- – Self-inject once monthly; avoid tender/bruised skin
- – Protect eyes/skin from sunlight for 24 hours post-dose (wear sunglasses, cover skin)
- – Report severe constipation, swelling, or breathing issues
- – Don’t shake device; discard if cloudy
Indication for This Patient
Preventive treatment of migraine in adults (episodic or chronic); reduces frequency of migraine days
Time
- * Timing: Once monthly (same day each month)
- * Onset: Effect begins within 1 week; full benefit in 4-12 weeks
- * Elimination: Half-life ~28 days; out of system in ~5 months
