CGRP Inhibitors: What They Are, How They Work, and What You Need to Know

When you hear CGRP inhibitors, a class of prescription drugs designed to block calcitonin gene-related peptide, a molecule linked to migraine attacks. Also known as anti-CGRP monoclonal antibodies, these drugs are one of the first treatments made specifically to stop migraines before they start—not just treat the pain after it hits. Unlike old-school meds like beta-blockers or antidepressants that were borrowed from other conditions, CGRP inhibitors target the actual biological pathway that triggers migraine pain. That’s why they work for so many people who’ve tried everything else and still get hammered by headaches.

These drugs are injected monthly or quarterly, and they don’t make you drowsy or foggy like some older migraine preventives. They’re not for every kind of headache—just chronic migraines, typically defined as 15 or more headache days a month, with at least 8 being full-blown migraines. If you’ve been stuck in a cycle of painkillers that stop working, or you’re tired of nausea and dizziness from triptans, CGRP inhibitors offer a cleaner, more targeted option. They’re also safer for people with heart or liver issues, since they don’t affect blood pressure or liver enzymes the way some older drugs do.

But they’re not magic. Some people don’t respond at all. Others see a 50% reduction in migraine days—enough to go back to work, sleep through the night, or play with their kids without fear of the next attack. And while they’re expensive, many insurance plans now cover them once you’ve tried at least two older preventives. The big names you’ll hear are erenumab, the first CGRP inhibitor approved by the FDA, sold as Aimovig, fremanezumab, sold as Ajovy, with quarterly dosing, and galcanezumab, sold as Emgality, often used when other preventives fail. There’s also a newer oral option, atogepant, a small-molecule CGRP receptor antagonist taken daily as a pill, which gives people who hate needles another way in.

These drugs don’t cure migraines. But they change the game. They give people back control. And they’re part of a bigger shift in neurology—away from trial-and-error prescribing, toward treatments built on real science of how the brain and nerves interact during a migraine. You’ll find stories below from people who went from bedridden to back on the trail, from skipping work every week to finally planning a vacation. You’ll also see warnings about cost, access, and the rare cases where side effects like constipation or injection reactions popped up. This isn’t a list of miracle cures. It’s a practical guide to what works, what doesn’t, and what to ask your doctor next time you sit down to talk about your headaches.