Ajovy (fremanezumab-vfrm) is an injectable calcitonin gene-related peptide antagonist indicated for the preventive treatment of migraine in adults.

People who suffer from migraine have increased levels of calcitonin gene‐related peptide (CGRP), a neuropeptide present in the nervous system. When CGRP binds to its receptor, it results in a cascade of events that contribute to the inflammation associated with migraine pain. Ajovy selectively targets the CGRP ligand and blocks its binding to the receptor, blocking this cascade of events and preventing a migraine attack.

Three other CGRP antagonists have been approved:

• Aimovig (erenumab-aooe) was the first approved CGRP antagonist. Aimovig binds potently and selectively to the CGRP receptor (not the ligand) to block CGRP activation, thereby preventing migraine pain.
• Emgality (galcanezumab-gnlm) has a similar mechanism of action to Ajovy; it binds to the CGRP ligand and blocks its binding to the receptor to help prevent migraine pain.
• Vyepti (eptinezumab-jjmr) also binds to the CGRP ligand and blocks its binding to the receptor.