Galcanezumab (Emgality®): A Monthly Injectable to Prevent Migraine and Cluster Headache

Looking for a detailed medication handout of Emgality®? Explore our downloadable handouts created by the specialists at the Ottawa Headache Centre.

Galcanezumab (Emgality®) is used for the prevention of episodic or chronic migraine and episodic cluster headache. It is administered with an auto-injector similar to an epinephrine-pen. It is self-injected once a month. The first injection includes 2 doses (a loading dose).

Who may benefit from galcanezumab (Emgality®)?

We consider galcanezumab (Emgality®) when:

• Patients continue to have frequent migraine attacks after trying two oral preventives

• Patients continue to have poorly controlled cluster headache attacks after trying one oral preventive

• Pregnancy is not foreseeable for at least 6 months

• There is a preference for infrequent dosing rather than taking a medication every day

• There is a preference for a self-administered medication at home rather than an intravenous treatment

How do you access galcanezumab (Emgality®) in Ottawa?

In Ontario, coverage for galcanezumab (Emgality®) often requires:

• Either a diagnosis of episodic or chronic migraine, or a diagnosis of episodic cluster headache

• Documentation of migraine frequency or cluster headache attacks

• For migraine, trials of at least two oral preventive medications at therapeutic doses (usually for ~3 months each, depending on insurer)

• For cluster headache, trial of at least one oral preventive medication at therapeutic doses

People without private insurance may be eligible to have the cost of galcanezumab (Emgality®) reimbursed through an application to the Exceptional Access Program.

We assist with:

• Insurance forms

• Prior authorization

At the Ottawa Headache Centre we will:

• Confirm your diagnosis and migraine burden

• Determine whether galcanezumab (Emgality®) is an appropriate option, and offer alternatives

• Discuss the evidence backing galcanezumab (Emgality®), its benefits, as well as side-effects

• Assist with any insurance forms

• Complete the prior authorization process that is needed

Next steps to get started on galcanezumab (Emgality®) in Ottawa

If you feel like you are getting nowhere with your migraine or cluster headache preventives, ask your doctor for a referral to the Ottawa Headache Centre and we will explore migraine-specific and cluster headache preventive options with you.

Galcanezumab (Emgality®) is a monoclonal antibody that binds to CGRP in the bloodstream, preventing it from activating pain pathways. 

By reducing CGRP activity, galcanezumab (Emgality®):

Next steps

Galcanezumab (Emgality®) is a versatile CGRP antagonist that is approved for the prevention of migraine and cluster headache. An expert evaluation that considers your diagnosis, migraine or cluster headache pattern, prior treatment history, preferences, and lifestyle values can help you determine whether it is the right preventive for you.

If you are considering Emgality® (or have been referred), our consultation helps:

• confirm whether galcanezumab (Emgality®) fits your migraine or cluster headache profile

• set realistic timelines for judging response

• and place it into a broader, individualized care plan (including acute and non-medication strategies).

Ask your doctor for a referral to the Ottawa Headache Centre if you want to learn more about your migraine-specific preventive options.

Disclaimer

This material is provided for educational purposes and does not replace independent clinical judgment or institutional protocols. Management decisions remain the responsibility of the treating clinician.