| Migraine Disorders
Emgality vs Relpax
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Emgality vs Relpax with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRelpax has a higher rate of injection site reactions vs Emgality based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Relpax but not Emgality, including UnitedHealthcare
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Category
Emgality
Relpax
At A Glance
SC injection
Monthly
CGRP antagonist
Oral
As needed
5-HT1B/1D agonist (triptan)
Indications
- Migraine Disorders
- Cluster Headache
- Migraine Disorders
Dosing
Migraine Disorders 240 mg loading dose (two consecutive SC injections of 120 mg each) once, followed by 120 mg SC monthly.
Cluster Headache 300 mg (three consecutive SC injections of 100 mg each) at the onset of the cluster period, then monthly until the end of the cluster period.
Migraine Disorders 20 mg or 40 mg orally for acute treatment; a second dose may be taken at least 2 hours after the first if migraine has not resolved or returns; maximum 80 mg/day.
Contraindications
- Serious hypersensitivity to galcanezumab-gnlm or any of the excipients
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or history or current evidence of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication such as dihydroergotamine (DHE) or methysergide
- Hypersensitivity to eletriptan or any excipient (angioedema and anaphylaxis seen)
- Recent use (within at least 72 hours) of potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir
Adverse Reactions
Most common (>=2%) Injection site reactions
Serious Hypersensitivity reactions, hypertension, Raynaud's phenomenon
Postmarketing Anaphylaxis, angioedema, rash, hypertension, Raynaud's phenomenon
Most common (>=2%) Asthenia, nausea, dizziness, somnolence, headache, paresthesia, flushing/feeling of warmth, chest tightness/pain/pressure, abdominal pain/discomfort, dry mouth, dyspepsia, dysphagia
Serious Myocardial ischemia and myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increase in blood pressure, hypersensitivity reactions
Postmarketing Seizure, vomiting
Pharmacology
Galcanezumab-gnlm is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor; it is not metabolized by cytochrome P450 enzymes, making interactions with CYP substrates, inducers, or inhibitors unlikely.
Eletriptan is a selective 5-HT1B/1D receptor agonist (triptan) that acts on intracranial blood vessel receptors and trigeminal sensory nerves to produce cranial vessel constriction and inhibit pro-inflammatory neuropeptide release.
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Most Common Insurance
Anthem BCBS
Emgality
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (10/12) · Qty limit (11/12)
Relpax
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Emgality
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (7/8) · Qty limit (8/8)
Relpax
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (7/8)
Humana
Emgality
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Relpax
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Relpax.
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EmgalityView full Emgality profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.