Erenumab (Aimovig) (Erenumab-aooe) for Personal Injury
Drug Class: CGRP Receptor Monoclonal Antibody — Preventive (Monthly Injection)
Common Uses
- Preventive treatment of episodic and chronic migraine
- Post-traumatic migraine prevention after car accidents or TBI
- Migraine prevention when oral preventives have failed
- Long-term preventive therapy requiring monthly dosing
How It Helps in Personal Injury Cases
Erenumab (Aimovig) is the first CGRP monoclonal antibody ever approved for migraine — FDA-approved in 2018. In personal injury cases, its monthly self-injection schedule creates a clear monthly documentation record for each month of preventive neurological treatment. A neurologist who prescribes Aimovig has made a clinical determination that the patient's migraine burden warrants biologic-class preventive therapy — strong evidence of significant neurological injury.
Unlike gepants which are small molecules that block CGRP in real time, erenumab is a large protein (monoclonal antibody) that specifically targets and neutralizes the CGRP receptor over a period of weeks. Monthly administration provides sustained CGRP receptor blockade between injections, reducing both the frequency and severity of migraine attacks. Erenumab is the only CGRP antibody that targets the receptor rather than the CGRP ligand itself.
Erenumab (Aimovig) for Post-Traumatic Migraine Prevention
Erenumab, sold as Aimovig, was the first CGRP monoclonal antibody approved for migraine prevention (FDA, May 2018). It is administered as a monthly subcutaneous injection and provides sustained preventive coverage against post-traumatic migraine.
How It Differs from Oral Gepants
Erenumab is a large protein biologic — a monoclonal antibody — rather than a small oral molecule. It targets the CGRP receptor specifically, neutralizing it for 3-4 weeks per injection. This extended duration of action is what makes monthly dosing possible.
Uniquely, erenumab targets the CGRP receptor itself — the other three injectable CGRP antibodies (galcanezumab, fremanezumab, eptinezumab) target the CGRP ligand instead. This receptor-targeting distinction may affect which patients respond best.
Dosing
- 70mg monthly — Standard starting dose
- 140mg monthly — For patients with inadequate response at 70mg
Self-administered by autoinjector pen in the abdomen, thigh, or upper arm.
Post-Traumatic Migraine Context
Physical trauma — especially whiplash and TBI — causes sustained CGRP pathway activation in susceptible patients. Monthly erenumab provides continuous CGRP receptor blockade during the recovery period, significantly reducing migraine frequency.
The STRIVE trial demonstrated a reduction of approximately 3.7 migraine days/month versus placebo at the 140mg dose in episodic migraine patients.
Documentation Value in PI Cases
Each monthly autoinjector dispensed by the pharmacy creates a dispensing record — 12 months of treatment equals 12 documented records of specialist-prescribed preventive neurological therapy. This is among the strongest pharmacological documentation of sustained neurological injury available in personal injury cases.
Accessing Erenumab Through LienScripts
Erenumab (Aimovig) is brand-name only with no biosimilar alternatives in the US. LienScripts provides pharmacy lien coverage at $0 upfront cost for qualified personal injury patients.
Dosage Forms
- Autoinjector pen 70mg/mL (monthly subcutaneous self-injection)
- Autoinjector pen 140mg/mL (monthly subcutaneous self-injection — for patients needing higher dose)
Common Side Effects
- Injection site reactions (mild redness, swelling)
- Constipation (more common than with other CGRP antibodies)
- Muscle spasm or cramp (uncommon)
- Fatigue (uncommon)
Frequently Asked Questions
How often is Aimovig injected?
Aimovig is injected once monthly using a prefilled autoinjector pen. Patients self-administer the injection subcutaneously (under the skin) in the abdomen, thigh, or upper arm. The injection takes seconds and most patients find it well-tolerated.
How long before Aimovig shows results?
Some patients notice reduced migraine frequency within the first month, but the full clinical benefit typically develops over 3-6 months of consistent monthly injections. Neurologists typically reassess at 3-6 months to determine if the dose needs adjustment.
Why would a neurologist choose Aimovig over an oral gepant?
Aimovig is often chosen when: (1) the patient prefers monthly injection over daily oral dosing, (2) prior gepant trials were insufficient, (3) the chronic migraine burden is severe and warrants biologic-class therapy, or (4) drug interactions preclude oral gepants.
Is there a biosimilar or generic for Aimovig?
No. Erenumab is not yet available as a biosimilar in the United States. Aimovig is the only available option.