Is CGRP safe for 45-year-old women with chronic migraine?

Question

Hello doctor,

I am a 45-year-old woman with chronic migraines, at least 15 headache days a month. I have tried Topiramate and beta-blockers with no lasting benefit. My neurologist mentioned CGRP (calcitonin gene-related peptide) targeting injections.

How do drugs like Erenumab or Fremanezumab work?
Are there risks for people with mild hypertension?
How soon do they show results?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Since you are experiencing chronic migraines with at least 15 headache days per month and have not responded well to traditional preventives like Topiramate or beta blockers, CGRP (calcitonin gene-related peptide) targeting injections such as Erenumab or Fremanezumab may be the best option.

These medications block calcitonin gene-related peptide (CGRP), a molecule involved in the pathway that triggers migraine pain and inflammation. Erenumab blocks the CGRP receptor, while Fremanezumab blocks the CGRP molecule itself. Both help reduce the frequency and severity of migraines.

These treatments are generally well tolerated and are injected once a month (or quarterly, depending on the formulation). Some people notice improvement within the first month, though full effects may take up to three months to manifest.

Regarding your mild hypertension, it is worth noting that Erenumab has been associated in rare cases with elevated blood pressure. So if your blood pressure is poorly controlled, we can consider Fremanezumab instead, which has not shown the same concern.

Overall, CGRP inhibitors have significantly improved the quality of life for many people with chronic migraine.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.