Galcanezumab for the prevention of migraine

18th January 2021 by Dr Louise Hudman

Galcanezumab for the prevention of migraine

This new guideline was published in November 2020 and is about galcanezumab for the prevention of migraine from NICE advising that galcanezumab can be used in the prevention of certain kinds of migraine.

What is galcanezumab?

  • It is a recombinant monoclonal antibody.
  • It is injected subcutaneously monthly (this would normally be self-injection).
  • It binds to CGRP (calcitonin gene-related peptide) and stops it binding to its receptor. CGRP is thought to play a role in migraines.

When can it be used?

It can be used in adults IF:

  • they have four or more migraine days a month AND
  • at least three other preventative drugs have failed.

It must be stopped after 12 weeks IF:

  • in episodic migraine, the headache frequency doesn’t reduce by at least 50% OR
  • in chronic migraine, the headache frequency doesn’t reduce by a least 30%.

How do we define episodic and chronic migraine?

  • Episodic migraine – Fewer than 15 headache days a month.
  • Chronic migraine – 15 or more headache days a month, with at least eight of these having migraine features.

Who should be prescribing this?

Read for free

Sign up to access everything.

Free trial


Already a member? Login to view this content.


"I am so glad and grateful for being a member of NASGP's BOB locum chambers. I started with them in a critical period of my career as I was a newly-qualified GP, looking for work in a new area with a new virus hardly hitting the world and the jobs market.

Richard and Ali's help was a godsend. They introduced me to locum work in a friendly and kind manner, provided valuable support and excellent service through the ever-improving LocumDeck and NASGP website. With the help of the chambers, I received a face to face tutorial on Emis (I trained on SystmOne) and my online profile was promoted on a growing network of GP practices throughout Buckinghamshire, Oxford and Berkshire.

I was able to work in different GP practices with different staff and patient demographics, massively increasing my clinical experience, resilience and communication skills.

It also helped me funnelling down all the job offers I received through my locum work until I recently agreed for a salaried position in a GP practice that I love working at. "

Dr Nazar Ahmed

See the full list of features within our NASGP membership plans