How do you use the migraine drug Ajovy?

Ajovy is given as a subcutaneous injection (under the skin) via a prefilled syringe or prefilled autoinjector either once a month, or once every three months. It can be self-administered after training by your healthcare provider.

Ajovy (fremanezumab-vfrm) is a long-acting injectable migraine preventive for adults that targets the calcitonin gene-related peptide (CGRP) and prevents receptor site binding.

Instructions for Use

Step 1. Check the dose your healthcare provider has prescribed.

There are two dosing options:

• 225 mg once every month
• 675 mg once every 3 months (quarterly).

If you use the 675 mg dose, you will use 3 separate injections one after another, using a different prefilled syringe or prefilled autoinjector for each injection.

Step 2. Remove the prefilled syringe or prefilled autoinjector from the carton. Do not shake.

Step 3. Gather the supplies you will need to inject your prescribed dose of Ajovy. This includes the Ajovy prefilled syringe(s) or prefilled autoinjector(s), alcohol swabs, gauze pads or cotton balls, and a sharps disposal container.

Step 4. Wait for 30 minutes to let Ajovy reach room temperature. Do not leave the prefilled syringe or prefilled autoinjector in direct sunlight. Do not warm using a heat source such as hot water or a microwave.

Step 5. Wash your hands.

Step 6. Look closely at your Ajovy prefilled syringe or prefilled autoinjector.

• You may see air bubbles. This is normal. Do not remove the air bubbles before giving your injection. The air bubbles will not harm you.
• Check that the liquid is clear and colorless to slightly yellow before you give your
  injection. Do not use Ajovy if the the liquid has any particles in it, or is discolored, cloudy, or frozen. Call your healthcare provider or pharmacist.

Step 7. Choose your injection area. Ajovy can be injected into the following areas:

• stomach area (abdomen), avoid about 2 inches around the belly button.
• the front of your thighs, an area that is at least 2 inches above the knee and 2 inches below the groin.
• the back of your upper arms, in the fleshy area of the upper back portion. You may need help from someone who has been instructed on how to give your injection if this area is hard to reach.

Step 8. Clean your injection area using a new alcohol swab. Let your skin dry.

• Do not inject Ajovy into an area that is tender, red, bruised, callused, tattooed, hard, or that has scars or stretch marks.
• Do not inject Ajovy in the same injection site that you inject other medicine.
• If you want to use the same injection area for the 3 separate injections needed for the 675 mg dose, make sure the second and third injections are not at the same spot you used for the other injections.

Step 9. Remove protective cap and do not replace.

Step 10. Give your injection.

Using the Ajovy prefilled syringe:

1. Use your free hand to gently pinch up at least 1 inch of the skin that you have cleaned.
2. Insert the needle into the pinched skin at a 45 to 90 degree angle.
3. When the needle is all the way into your skin, use your thumb to push the plunger.
4. Push the plunger slowly all the way down as far as it will go to inject all of the medicine.
5. Remove the needle from your skin. Do not recap the needle at any time to avoid injury and infection.

Using the Ajovy prefilled autoinjector:

1. Place the prefilled autoinjector at a 90 degree angle against your skin at the injection site you have cleaned.
2. Press down on the prefilled autoinjector and keep holding it down against the skin for about 30 seconds. Do not remove pressure until the 3 steps below are complete.
   1. You hear the first “click” (this means the injection has started and the blue plunger starts to move).
   2. You hear a second “click” (about 15 seconds after the first click. The plunger will be moving to the bottom of the viewing window as the medicine is being injected.)
   3. You wait another 10 seconds. (to make sure all the medicine is injected).
3. Check that the blue plunger has filled the viewing window and remove the autoinjector from the skin by lifting the prefilled autoinjector straight up. Note: When the blue plunger has filled the viewing window you will be able to see the gray stopper. As the prefilled autoinjector is lifted from the skin, the needle shield returns to the original position and locks into place, covering the needle. Do not try to put the protective cap back on the used prefilled autoinjector as it is no longer needed. Do not try to re-use the prefilled autoinjector.

Step 11. Apply pressure to the injection site.

• Use a clean, dry cotton ball, or gauze pad to gently press on the injection site for a few seconds.
• Do not rub the injection site.
• Do not re-use the prefilled syringe or prefilled autoinjector.

Step 12. Dispose of your prefilled syringe or prefilled autoinjector s in a sharps disposal container right away after use.

For additional information, see Ajovy information for professionals.

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