Emgality Has Very Few Drug Interactions — But There Are Still Things You Should Know

One of the advantages of Emgality (Galcanezumab) compared to older migraine prevention medications is its remarkably clean interaction profile. Because Emgality is a monoclonal antibody — a large protein — it is not processed by the liver's cytochrome P450 enzyme system, which is where most drug-drug interactions happen.

That said, "very few interactions" doesn't mean "zero things to think about." Here's what you should know before starting Emgality, and what to tell your doctor.

How Drug Interactions Work

Most drug interactions happen because two medications are processed by the same enzyme in the liver. When they compete for the same enzyme, one or both drugs can build up to higher-than-expected levels (increasing side effects) or get broken down too quickly (reducing effectiveness).

Emgality sidesteps this entire problem. As a monoclonal antibody, it's broken down through catabolism — the body's natural protein recycling process — not by liver enzymes. This means it doesn't compete with other drugs for processing, and other drugs generally don't affect Emgality's levels in your body.

Medications That May Interact With Emgality

Other CGRP Antibodies (Avoid Combining)

The only notable drug interactions listed for Emgality are with other medications in the same class:

• Aimovig (Erenumab) — Another CGRP-targeting monoclonal antibody
• Ajovy (Fremanezumab) — Another anti-CGRP monoclonal antibody
• Vyepti (Eptinezumab) — IV-infused anti-CGRP monoclonal antibody

These are classified as minor interactions, but the reason to avoid combining them is simple: it's redundant. Taking two CGRP antibodies at the same time doesn't provide additional benefit and could increase the chance of side effects. If Emgality isn't working well enough, your doctor would typically switch you to a different CGRP antibody rather than add one on top.

Oral CGRP Antagonists (Gepants)

Medications like Qulipta (Atogepant), Nurtec (Rimegepant), and Ubrelvy (Ubrogepant) also target the CGRP pathway but work differently — they block the CGRP receptor directly and are processed by the liver. While there is no established dangerous interaction between Emgality and gepants, using both a CGRP antibody and an oral CGRP blocker simultaneously is an area of ongoing research. Some doctors do prescribe both (for example, Emgality for prevention plus Nurtec as needed for acute attacks), but this should be done under medical supervision.

Triptans

Triptans like Sumatriptan (Imitrex), Rizatriptan (Maxalt), and Zolmitriptan (Zomig) are commonly used alongside Emgality without issue. Triptans are acute migraine treatments that work through the serotonin pathway, which is completely separate from CGRP. It is safe to use triptans for breakthrough migraines while on Emgality.

Other Common Migraine Medications

Emgality does not have clinically significant interactions with:

• Topiramate (Topamax) — an older migraine preventive
• Propranolol (Inderal) — a beta-blocker used for migraine prevention
• Amitriptyline (Elavil) — a tricyclic antidepressant sometimes used for migraines
• Botox (OnabotulinumtoxinA) — used for chronic migraine
• NSAIDs like Ibuprofen (Advil) or Naproxen (Aleve)
• Acetaminophen (Tylenol)

This is a significant advantage over older preventive medications that often had long lists of interactions.

Supplements and Over-the-Counter Products

Because Emgality is not metabolized by liver enzymes, common supplements are generally safe to take alongside it:

• Magnesium — Commonly used for migraine prevention; no known interaction with Emgality
• Riboflavin (Vitamin B2) — Another popular migraine supplement; no interaction
• CoQ10 — No known interaction
• Feverfew — An herbal supplement used for headaches; no known interaction with Emgality, though limited data exists
• Butterbur — Sometimes used for migraines; no known interaction with Emgality, but quality and safety of butterbur supplements vary

Even though these supplements appear safe with Emgality, it's always good practice to tell your doctor about everything you take — including vitamins, herbs, and over-the-counter medications.

Food and Drink Interactions

There are no known food or drink interactions with Emgality. You do not need to adjust your diet, avoid alcohol, or time your injection around meals. This is another area where Emgality's monoclonal antibody structure works in the patient's favor — because it's not processed through the digestive system or liver enzymes, food and beverages don't affect it.

That said, alcohol is a common migraine trigger for many people. While alcohol won't interact with Emgality pharmacologically, you may still want to moderate your intake as part of your overall migraine management plan.

What to Tell Your Doctor Before Starting Emgality

Even though Emgality has very few interactions, it's important to give your doctor a complete picture of your health. Before your first injection, make sure they know about:

• All prescription medications you currently take — especially other migraine treatments
• Over-the-counter medications you use regularly (pain relievers, allergy medications, etc.)
• Supplements and herbal products
• Other injectable medications — including insulin, blood thinners, or other biologics
• Any history of allergic reactions to injectable medications or monoclonal antibodies
• Pregnancy or plans to become pregnant — limited data on Emgality in pregnancy
• Breastfeeding status — unknown if Galcanezumab passes into breast milk

Your doctor and pharmacist can review your complete medication list and confirm there are no concerns specific to your situation.

Final Thoughts

Emgality's drug interaction profile is one of its biggest strengths. Unlike older migraine preventives that often came with long lists of interactions and dietary restrictions, Emgality plays nicely with most other medications — including triptans, NSAIDs, and common migraine supplements.

The main thing to avoid is combining Emgality with other CGRP antibodies, which is redundant rather than dangerous. Beyond that, the most important step is simply telling your doctor about everything you take so they can make the best treatment decisions for you.

For more information about Emgality, including side effects, dosage information, and savings programs, explore our other Emgality guides. And when you're ready to fill your prescription, Medfinder can help you find it in stock.