Galcanezumab
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Anti-CGRP ligand monoclonal antibody
Galcanezumab
Emgality
Galcanezumab (brand name Emgality) is a humanized monoclonal antibody targeting the CGRP peptide, FDA-approved in 2018 for migraine prevention and in 2019 for episodic cluster headache prevention.
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Summary
Classes
Anti-CGRP ligand monoclonal antibody
Common uses
Preventive treatment of migraine in adults; episodic cluster headache
Pharmacy
Starting dose
Migraine: 240 mg SC loading dose, then 120 mg SC monthly. Cluster: 300 mg SC at onset of cluster period, then monthly during cluster.
Preparations
120 mg/mL prefilled syringe or autoinjector
US FDA Max
240 mg loading + 120 mg/month for migraine; 300 mg/month for cluster
Pharmacology
Routes
Subcutaneous
Onset
Over weeks
Duration
Monthly dosing
Half-life
~27 days
Bioavailability
Not formally established (high SC)
Pregnancy
Limited data; avoid
Legal status
Rx
Purported mechanism
Humanized IgG4 monoclonal antibody binding CGRP peptide; prevents CGRP from activating its receptor