Does Aimovig Cause Constipation?
Aimovig (erenumab) lists constipation as a common side effect in clinical trials and prescribing information. In studies, 1-6% of patients reported constipation, compared to less than 1% on placebo.[1][2] It's typically mild but can persist or lead to more serious issues like bowel obstruction in rare cases.
How Common Is Constipation with Aimovig?
Constipation occurred in up to 3% of patients in pivotal trials like STRIVE and ARISE, often starting within the first month. Risk factors include female sex, opioid use, or prior gastrointestinal issues. Manufacturers note it affects about 1 in 20 users, higher than placebo rates.[1][3]
Why Does Aimovig Cause Constipation?
Aimovig blocks CGRP receptors, which regulate pain but also influence gut motility. This can slow intestinal movement, leading to constipation. Unlike triptans, it doesn't directly affect serotonin pathways tied to serotonin syndrome risks.[2][4]
What Do Patients Report About Constipation?
User reviews on forums and sites like Drugs.com show mixed experiences: some describe severe, ongoing constipation requiring laxatives, while others have none. About 10-15% of Aimovig reviews mention it as a top complaint, sometimes prompting discontinuation.[5]
How to Manage Constipation on Aimovig?
Doctors recommend hydration, fiber-rich diets, exercise, and over-the-counter laxatives like polyethylene glycol. If severe, they may switch to monthly dosing or alternatives. Monitor for ileus or obstruction, which occurred in post-marketing reports.[1][2]
Does Constipation Lead to Quitting Aimovig?
Yes, for some: in trials, 0.4% stopped due to constipation. Real-world data suggests higher dropout rates from GI effects.[3]
Alternatives to Aimovig with Lower Constipation Risk
| Drug | Constipation Rate | Key Difference |
|------|------------------|---------------|
| Emgality (galcanezumab) | <2% | Monthly injection, similar CGRP target |
| Ajovy (fremanezumab) | 1-2% | Quarterly option available |
| Nurtec ODT (rimegepant) | Rare | Acute/on-demand, oral |
| Ubrelvy (ubrogepant) | <1% | Acute relief only |
These gepants like Nurtec have lower GI risks overall.[2][6]
[1]: Aimovig Prescribing Information (FDA)
[2]: Amgen Aimovig Safety Data
[3]: NEJM STRIVE Trial (2017)
[4]: CGRP Mechanism Review (Nature Reviews, 2020)
[5]: Drugs.com Aimovig Reviews
[6]: Migraine Preventive Comparison (AAFP, 2023)