What Is Ajovy?

Ajovy (Fremanezumab-vfrm) is an injectable prescription medication used for the preventive treatment of migraine in adults and pediatric patients aged 12 and older.

Ajovy belongs to a class of drugs called CGRP inhibitors — calcitonin gene-related peptide inhibitors. It's a humanized monoclonal antibody manufactured by Teva Pharmaceuticals. The FDA first approved Ajovy in September 2018 for adult migraine prevention, and it has since been approved for adolescents aged 12 and older weighing at least 45 kg. Ajovy is not a controlled substance.

Unlike acute migraine treatments that stop an attack in progress, Ajovy is a preventive medication. It's designed to reduce the number of migraine days you experience each month before they happen. To understand how Ajovy works at a molecular level, see our mechanism of action guide.

What Is Ajovy Used For?

Ajovy is FDA-approved for:

• Preventive treatment of migraine in adults — This includes both episodic migraine (fewer than 15 headache days per month) and chronic migraine (15 or more headache days per month, with at least 8 having migraine features).
• Preventive treatment of migraine in pediatric patients — Approved for patients aged 12 years and older weighing at least 45 kg, using the same dosing as adults.

Ajovy is typically prescribed for patients who experience 4 or more migraine days per month and who may benefit from preventive therapy. It is not used to treat a migraine attack that has already started — for acute treatment, other medications like triptans or gepants are used.

Off-Label Uses

Some healthcare providers prescribe Ajovy off-label for conditions including:

• Cluster headache prevention (limited evidence)
• New daily persistent headache

These uses are not FDA-approved, and evidence for them is still limited. Always discuss off-label use with your doctor.

How Is Ajovy Taken?

Ajovy is given as a subcutaneous injection — a shot under the skin — in the abdomen, thigh, or upper arm. It comes in two forms:

• Prefilled syringe — 225 mg/1.5 mL
• Prefilled autoinjector (pen) — 225 mg/1.5 mL

You have two dosing options:

1. Monthly dosing — One injection of 225 mg once a month
2. Quarterly dosing — Three injections of 225 mg each (675 mg total), given consecutively at different injection sites, once every three months

Both dosing schedules have been shown to be effective in clinical trials. The quarterly option is convenient for patients who prefer fewer injection days per year — just four sessions instead of twelve.

How to Self-Inject Ajovy

• Remove the prefilled syringe or autoinjector from the refrigerator and let it sit at room temperature for 30 minutes before use.
• Choose an injection site (abdomen, thigh, or upper arm) and clean the area with an alcohol wipe.
• Follow the instructions provided with your specific device (syringe or autoinjector).
• Rotate injection sites with each dose to minimize injection site reactions.
• For the quarterly dose, give three injections at three different sites during the same session.

Your healthcare provider will train you on proper injection technique before your first self-administered dose.

Who Should Not Take Ajovy?

Ajovy is contraindicated in patients with:

• Serious hypersensitivity to Fremanezumab-vfrm or any of the excipients (inactive ingredients) in the formulation
• History of anaphylaxis or angioedema related to Ajovy

Additionally, use caution in these situations:

• Pregnancy — Ajovy is not recommended during pregnancy unless the benefit outweighs the risk. Talk to your doctor if you're pregnant or planning to become pregnant.
• Breastfeeding — It's unknown whether Ajovy passes into breast milk. Discuss with your healthcare provider.

For a detailed look at potential reactions, read our guide to Ajovy side effects.

How Much Does Ajovy Cost?

Ajovy is a brand-name biologic medication with no generic or biosimilar currently available. Here's what you can expect to pay:

• Without insurance — Approximately $690 to $1,019 per monthly dose (one 225 mg/1.5 mL injection)
• With commercial insurance — Most plans cover Ajovy but require prior authorization and often step therapy (trying other preventive medications first). Your copay will depend on your plan's formulary tier.
• Ajovy Savings Card — Commercially insured patients may pay as little as $0 to $15 per prescription through Teva's savings program. Visit ajovy.com/savings or call 1-800-671-3674.
• Patient assistance — Uninsured or underinsured patients who meet income criteria may qualify for free Ajovy through the Teva Cares Foundation Patient Assistance Program (1-877-237-4881 or tevacares.org).
• Medicare/Medicaid — Coverage varies. Medicare Part D may cover Ajovy but with higher cost-sharing. Medicaid coverage varies by state and typically requires prior authorization.

For more details on reducing your costs, see our complete guide to saving money on Ajovy.

How Does Ajovy Compare to Other Migraine Preventives?

Ajovy is one of several CGRP-targeting medications available for migraine prevention. Here's a quick comparison:

• Aimovig (Erenumab) — Monthly autoinjector; blocks the CGRP receptor rather than CGRP itself
• Emgality (Galcanezumab) — Monthly injection; also targets CGRP directly, similar to Ajovy
• Vyepti (Eptinezumab) — Quarterly IV infusion administered in a healthcare setting
• Qulipta (Atogepant) — Daily oral tablet; the only oral CGRP option for prevention

Ajovy's unique advantage is its flexible dosing — you can choose between monthly and quarterly injections, both self-administered at home. For a deeper comparison, see our guide to alternatives to Ajovy.

Final Thoughts

Ajovy is a well-established, FDA-approved option for preventing migraines in adults and adolescents. With flexible monthly or quarterly dosing, a manageable side effect profile, and multiple savings programs available, it's a viable option for many migraine patients — especially those who haven't found relief with older preventive medications.

If you think Ajovy might be right for you, talk to a neurologist or headache specialist about whether it's a good fit. And if you need help finding it at a pharmacy, Medfinder can show you where it's in stock near you.