Fremanezumab belongs to the class of medications called monoclonal antibodies, specifically, it is an anti-calcitonin gene-related peptide (anti-CGRP). It is used to prevent migraines for adults who experience 4 or more migraine days each month.

It works by reducing the activity of a substance called calcitonin gene-related peptide. It is believed that increased levels of this peptide in the blood contributes to migraines.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.  

The recommended adult starting dose of fremanezumab is 225 mg injected subcutaneously (under the skin) once a month. Alternatively, a dose of 3 separate injections of 225 mg (675 mg total) may be injected consecutively once every 3 months. The medication should be injected on your stomach area (abdomen), upper thigh, or upper arm, exactly as instructed by your doctor. Follow the schedule as prescribed by your doctor.

Your doctor or nurse will help you prepare and inject your first dose (or first few doses) and can teach you how to give yourself the injection at home. Do not attempt to inject this medication on your own until you completely understand how to inject a dose. If you are unsure of how to prepare or administer a dose, ask a health care professional. If you are having difficulty giving yourself injections, ask a family member or other caregiver for help if they are willing to become involved with your treatment and are willing to learn how to give you your injections.

Avoid injecting this medication into an area of skin that is sore, red, infected, or otherwise damaged. If your prescribed dose is 675 mg (3 injections of 225 mg) every 3 months, you may use the same body area for all 3 injections, but do not inject them into the same spot.

Fremanezumab should be clear and colourless to slightly yellow. Do not use the syringe if you notice particles or anything unusual in the appearance of the solution. Remove the syringe from the refrigerator and allow it to warm to room temperature for 30 minutes before injecting the dose. Do not shake the syringe, as this may cause the medication to break down and not be effective.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible. If you are on the once monthly injection schedule, inject your next dose one month after the late dose. If you are on the every 3 month injection schedule, inject your next dose 3 months after the late dose. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication in the refrigerator in its original carton, to protect it from light. Do not allow the medication to freeze. After it has been removed from the refrigerator, it must be used within 7 days. Keep it out of the reach of children.

Each 1.5 mL of sterile, preservative-free, clear-to-opalescent and colourless-to-slightly-yellow, solution, contains 225 mg of fremanezumab. Nonmedicinal ingredients: disodium ethylenediaminetetraacetic acid dehydrate (EDTA), L-histidine, polysorbate 80, sucrose, and water for injection.

Latex-free.

Do not take this medication if you are allergic to fremanezumab or any ingredients of the medication.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• back pain
• dizziness
• fatigue
• hives
• joint pain
• raised red or purple skin patches
• rash, itching, or pain at the injection site
• skin reddening
• stomach discomfort

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• severe itching at the injection site

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Heart and cardiovascular disease: People with heart disease and circulatory problems were not included in studies of this medication. The safety and effectiveness of using this medication have not been established for people with heart disease, stroke, or blood clots. If you have a history of heart disease or blood clots, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if fremanezumab passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. 

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.