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Emgality (Galcanezumab-gnlm) is a prescription biologic medication manufactured by Eli Lilly and Company. It belongs to the CGRP (calcitonin gene-related peptide) antagonist class and is a humanized monoclonal antibody. Emgality is FDA-approved for two indications:
Emgality is self-administered as a subcutaneous injection once monthly in the abdomen, thigh, or back of the upper arm.
Emgality works by binding to and neutralizing calcitonin gene-related peptide (CGRP), a neuropeptide that plays a key role in migraine and cluster headache pathophysiology. CGRP promotes blood vessel dilation and pain signaling in the brain. By blocking CGRP before it can bind to its receptors, Emgality helps prevent migraine attacks and reduces cluster headache frequency.
Unlike oral CGRP antagonists (gepants), Emgality is a monoclonal antibody that stays active in the body for weeks, which is why it only needs to be injected once a month. It is not metabolized by the liver or kidneys — instead, it is broken down naturally through catabolism like other antibodies.
For migraine prevention, the typical regimen is a 240 mg loading dose (two 120 mg injections) followed by 120 mg once monthly. For episodic cluster headache, the dose is 300 mg (three 100 mg injections) once monthly.
Emgality (Galcanezumab) has a findability score of 45 out of 100, meaning it is frequently difficult to find in stock. Emgality has been listed on the ASHP drug shortage list due to increased demand, and patients have reported intermittent difficulty filling prescriptions at major chain pharmacies like CVS and Walgreens since late 2022. As a biologic with no biosimilar available, supply constraints from manufacturer Eli Lilly can lead to localized shortages. Using a tool like Medfinder can help you locate pharmacies that currently have Emgality in stock near you.
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Emgality can be prescribed by several types of healthcare providers, including:
Telehealth consultations are also available for Emgality prescriptions. Most insurance plans require prior authorization before covering Emgality, and many require step therapy (trying and failing other preventive medications first). You can use Medfinder to find providers who prescribe Emgality near you.
No, Emgality is not a controlled substance. It has no DEA scheduling and carries no risk of abuse or dependence. Emgality is a monoclonal antibody biologic that does not affect the central nervous system in a way that could lead to addiction. It does not require special prescribing procedures associated with controlled substances.
Serious but rare side effects include hypersensitivity reactions (difficulty breathing, hives, rash), anaphylaxis, and angioedema. Emgality carries no boxed warning. Contact your healthcare provider immediately if you experience signs of a severe allergic reaction after injection.
If you cannot find Emgality in stock or it is not covered by your insurance, several alternatives are available in the CGRP class:
Traditional preventive migraine medications such as Topiramate, Propranolol, and Amitriptyline may also be options. Talk to your doctor about which alternative is right for you.
Emgality has a very favorable drug interaction profile. As a monoclonal antibody, it is not metabolized by cytochrome P450 enzymes and is unlikely to interact with most medications.
Always inform your doctor of all medications you are taking, but Emgality is considered very safe from a drug interaction standpoint.
Emgality is an effective and well-tolerated CGRP monoclonal antibody for preventing migraines and treating episodic cluster headaches. However, with a findability score of just 45 out of 100, patients may face challenges locating it in stock due to ongoing supply constraints. The high cash price of $700–$950 per month makes savings programs essential — Eli Lilly's savings card can reduce costs to as little as $0–$35 per month for commercially insured patients, and the Lilly Cares patient assistance program provides the medication free to qualifying uninsured patients.
If you're struggling to find Emgality at your local pharmacy, try using Medfinder to check real-time availability at pharmacies near you. You can also ask your prescriber about specialty pharmacies, which may have more reliable stock.
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