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Emgality (galcanezumab-gnlm)
galcanezumab
Adult Dosing .
Dosage forms: INJ (pen): 120 mg per injection; INJ (pre-filled syringe): 100 mg per mL, 120 mg per mL
Special Note
- [drug name clarification]
- Info: nonproprietary name = galcanezumab-gnlm
migraine prophylaxis
- [120 mg SC qmo]
- Start: 240 mg SC x1
cluster headache, episodic
- [300 mg SC qmo]
- Start: 300 mg SC x1 at onset of cluster period; Info: continue tx until end of cluster period
renal dosing
- [see below]
- mild-moderate impairment: no adjustment; severe impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: HTN
- caution: Raynaud phenomenon
Drug Interactions .
Overview
galcanezumab
CGRP antagonist
- hypertensive effects
Avoid/Use Alternative
- atogepant
- epinephrine inhaled
- eptinezumab
- erenumab
- fremanezumab
- furosemide
- galcanezumab
- midodrine
- rimegepant
- ubrogepant
- zavegepant
Monitor/Modify Tx
- abiraterone acetate
- acebutolol
- albuterol
- albuterol inhaled
- aliskiren
- almotriptan
- amiloride
- amlodipine
- amphetamine
- angiotensin II
- aprocitentan
- arformoterol inhaled
- armodafinil
- asciminib
- atenolol
- atomoxetine
- atropine ophthalmic
- axitinib
- azilsartan medoxomil
- benazepril
- benzphetamine
- betamethasone
- betaxolol
- bevacizumab
- bismuth subsalicylate
- bisoprolol
- brigatinib
- budesonide
- bumetanide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- candesartan cilexetil
- cannabis
- captopril
- carfilzomib
- carvedilol
- celecoxib
- chlorothiazide
- chlorthalidone
- clevidipine
- clonidine
- cocaine
- copanlisib
- corticotropin
- cortisone
- cyclosporine
- danazol
- darbepoetin alfa
- deflazacort
- desmopressin
- desvenlafaxine
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- dihydroergotamine
- diltiazem
- dobutamine
- dopamine
- doxapram
- doxazosin
- dronabinol
- droxidopa
- eletriptan
- enalapril
- enalaprilat
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- eplerenone
- epoetin alfa
- ergotamine
- esketamine
- esmolol
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethacrynic acid
- ethanol (alcoholic beverage)
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- felodipine
- fenfluramine
- fenoldopam
- fenoprofen
- fingolimod
- fludrocortisone
- flurbiprofen
- formoterol inhaled
- fosinopril
- fostamatinib
- frovatriptan
- fruquintinib
- guanfacine
- hoodia
- hydralazine
- hydrochlorothiazide
- hydrocortisone
- hydroxocobalamin IV
- ibrutinib
- ibuprofen
- indapamide
- indomethacin
- irbesartan
- isradipine
- ketamine
- ketoprofen
- ketorolac
- labetalol
- lanreotide
- leflunomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- licorice
- lisdexamfetamine
- lisinopril
- lorlatinib
- losartan
- lumacaftor/ivacaftor
- luspatercept
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylergonovine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- metolazone
- metoprolol
- milnacipran
- minoxidil
- mirabegron
- modafinil
- moexipril
- nabumetone
- nadolol
- naproxen
- naratriptan
- naxitamab
- nebivolol
- nicardipine
- nifedipine
- nimodipine
- niraparib
- nisoldipine
- norepinephrine
- obinutuzumab
- olmesartan medoxomil
- olodaterol inhaled
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pazopanib
- perindopril
- pexidartinib
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pindolol
- piroxicam
- ponatinib
- ponesimod
- pralsetinib
- prazosin
- prednisolone
- prednisone
- propranolol
- pseudoephedrine
- quetiapine
- quinapril
- ramipril
- ramucirumab
- regorafenib
- ripretinib
- rizatriptan
- ropinirole
- rotigotine transdermal
- salmeterol inhaled
- salsalate
- selpercatinib
- siponimod
- solriamfetol
- sorafenib
- spironolactone
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- telmisartan
- terazosin
- terbutaline
- teriflunomide
- testosterone
- timolol
- tivozanib
- tolmetin
- torsemide
- trametinib
- trandolapril
- triamcinolone
- triamterene
- vadadustat
- valsartan
- vamorolone
- vandetanib
- vasopressin
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- voclosporin
- yohimbe
- ziv-aflibercept
- zolmitriptan
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- HTN
- Raynaud phenomenon
Common Reactions
- injection site reaction
- hypersensitivity reaction
- rash
- urticaria
- dyspnea
Safety/Monitoring .
Monitoring Parameters
BP
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; no known risk of fetal harm based on animal data at 18-64x recommended human dose
Pregnancy Registry
enroll patients or encourage patients to enroll in Migraine Pregnancy Registry at 1-833-464-4724 or www.migrainepregnancyregistry.com
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: for galcanezumab: unknown; CYP450: none
Excretion: for galcanezumab: unknown; Half-life: 27 days
Subclass: CGRP Inhibitors ; Headache/Migraine
Mechanism of Action
for galcanezumab: blocks calcitonin gene-related peptide (CGRP) activity (monoclonal antibody)
Formulary .
No Formulary Selected
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