[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [CGRP antagonists (gepants and anti-CGRP antibodies)](https://durgical.com/en/pharmacology/classes/cgrp-antagonists/) › Fremanezumab

# Fremanezumab

## CGRP antagonists (gepants and anti-CGRP antibodies)?

CGRP antagonists (gepants and anti-CGRP antibodies)

A monoclonal antibody that traps the CGRP peptide. Injected under the skin monthly or every three months to prevent migraine.

Updated Nov 1, 2026

Also called: Fremanezumab-vfrm

## Quick facts

**Group**
[CGRP antagonists (gepants and anti-CGRP antibodies)](https://durgical.com/en/pharmacology/classes/cgrp-antagonists/)

**Target**
CGRP peptide (the ligand, not the receptor)

**Used for**
Prevention of migraine in adults

**Key effects**
Pain

**Monitor**
Headache diary to judge the benefit · Blood pressure

**ATC**
N02CD03

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Fremanezumab is a monoclonal antibody that binds the CGRP peptide itself and stops it from reaching and activating its receptor. Less CGRP signalling from the trigeminal system means less vasodilation and neurogenic inflammation, and fewer migraine days over the following months.

- Fremanezumab binds circulating CGRP
- CGRP cannot reach its receptor
- Less trigeminovascular inflammation
- Fewer migraine days

## Indications

- Prevention of migraine in adults [Migraine →](https://durgical.com/en/conditions/migraine/)

## Adverse effects

### Common

- Pain, swelling or redness at the injection site

### Serious (rare, important)

- Allergic reactions, which can appear up to a month after the injection: hives, flushing, swelling, difficulty breathing
- Raynaud phenomenon: numb, cold, painful or discoloured fingers or toes

## Contraindications

- Hypersensitivity to fremanezumab or any component of the product

## Key interactions

**Acute migraine medicines**
Still needed for attacks: fremanezumab prevents migraine but does not stop an attack

## What is monitored

- Headache diary to judge the benefit
- Blood pressure
- Fingers and toes for Raynaud symptoms

## Administration and safety

- Taken out of the refrigerator and left about 30 minutes to reach room temperature, never warmed
- Injected under the skin of the thigh, upper arm or abdomen, avoiding tender, bruised, red or scarred skin
- The three-monthly regimen is three injections one after another
- Each syringe or device is used once and discarded in a sharps container

## Pregnancy and breastfeeding

There is little information in pregnancy; it is a decision for the treating team.

## Nursing care

- Teach injection technique and safe sharps disposal
- Ask about high blood pressure and Raynaud phenomenon
- Explain that allergic reactions can be delayed by days to weeks
- Remind that attack medicines are still needed

## Pharmacokinetics

**Absorption**
Subcutaneous injection

**Elimination**
Long-acting antibody: given monthly or every three months

## Memory aid

«FREMAnezumab FREEzes the peptide»: it grabs CGRP itself, not its receptor.

## Test yourself

Think of the answer, then tap the question to see it.

## What does fremanezumab bind?

The CGRP peptide (the ligand), not its receptor.

## How often is fremanezumab given?

Once a month or once every three months, under the skin.

## Which anti-CGRP antibody binds the receptor instead of the peptide?

Erenumab.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/fremanezumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Galcanezumab](https://durgical.com/en/pharmacology/galcanezumab/)
- [Erenumab](https://durgical.com/en/pharmacology/erenumab/)
- [Atogepant](https://durgical.com/en/pharmacology/atogepant/)

## Related conditions 1

- [Migraine](https://durgical.com/en/conditions/migraine/)

[← Back to the class: CGRP antagonists (gepants and anti-CGRP antibodies)](https://durgical.com/en/pharmacology/classes/cgrp-antagonists/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Fremanezumab-vfrm Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a618053.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N02CD03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/fremanezumab/