Aimovig autoinjector didn’t do full dose

[u/FormidableCat27]

I took my third dose of Aimovig this morning, and I didn’t get the full dose. I’m thinking it might be because I put an ice pack on my leg where I was doing the injection. I crave the cold and thought that not being able to feel the injection as much would help (I’m recovering from a very severe phobia of needles), but now I’m reading that having tense muscles can mean that the autoinjector can’t do the full dose. (Obviously cold ice pack = tense/restricted muscles.)

The window was completely yellow like it said that it was supposed to be, but when I lifted the autoinjector, the rest of the Aimovig shot out of the bottom of the autoinjector for about two seconds, getting on my leg. If I had to guess, I’d say that maybe a quarter to a third (at the absolute most) didn’t get into my leg. (I do it on my lower thigh and don’t want to do it on my stomach because I read that you’re not supposed to do it near stretch marks, and pretty much my entire stomach has stretch marks. It would give me too much anxiety to try to avoid them, so I’m going to continue to do it on my thighs.) I’m pretty sure that I held it there for at least 15 seconds, but maybe I was rushing because for me, needle = no thoughts. The window was fully yellow though, so my guess is that my muscles were too tense for the rest to go in.

Has anyone else had this happen, and what sort of reactions did you have? I nearly passed out afterwards, but I think it was from the anxiety and coming down from being very, very tense. Currently laying down with a fan on me in the middle of winter (I truly crave the cold). I did the ice pack last month, and I didn’t have any problems. I don’t know if I’ll be brave enough to do it next month without the ice pack; should I just try next month to do it without or should I maybe try to do the ice pack for less time?

I think that the Aimovig already started helping my first month, and I only had two prodromes last month that I was able to prevent from becoming a full-blown migraines through abortives. With this in mind, I should probably be mostly okay with the migraines this month, right? I have a CPA exam on Wednesday, so I’m super nervous about potentially getting migraines in the next four days.

Any advice from other autoinjector users who have a phobia of needles would be greatly appreciated.

Obligatory: I obviously messaged my neurologist and asked her the same questions but in not as many words.

[u/toolatetothenamegame]

i agree that this is a question for your pharmacy. i can't imagine this is a problem of you icing your leg - icing the leg beforehand is actually common advice to make the injection easier

[u/businessgoos3]

I'm not a doctor or a pharmacist but I'm not aware of it being an issue to be tense or to use an I've pack on the skin, when injecting aimovig, so long as you let the med thaw beforehand. It sounds like there may have been an issue with the injector itself? Your pharmacy that dispensed the aimovig would also be a good place to ask about this, though.

For the record, I always injected aimovig in my abdomen that is full of stretch marks and that was by far the least painful spot, so it may be worth a try, because that spot never hurt for me. Something else that might help is getting some lidocaine cream from the store (if you're in the US, it should be over the counter) and putting it on the area you want to inject, then putting a dressing on and letting it sit for about 30 minutes, then wiping it off and sanitizing and injecting like normal. That's what they do at my local children's hospital for my IV placements and it's great for helping prevent the needlestick pain; I wish more adult hospitals/clinics offered this kind of thing.