BACKGROUND: Erenumab is a human anti-calcitonin gene-related peptide monoclonal 
antibody developed for migraine prevention. Migraine predominately affects women 
of childbearing age; thus, it is important to determine potential drug-drug 
interactions between a common oral contraceptive and drugs used to treat 
migraine.
OBJECTIVES: We sought to evaluate potential drug-drug interactions between 
erenumab and a common oral contraceptive.
METHODS: Healthy women received three cycles of a norgestimate/ethinyl 
estradiol-containing oral contraceptive with a single 140-mg subcutaneous dose 
of erenumab during cycle three. Norgestimate metabolites (norgestrel and 
norelgestromin) and ethinyl estradiol pharmacokinetics were evaluated in the 
absence and presence of erenumab. Primary endpoint was peak plasma concentration 
(Cmax) and area under concentration-time curve from time 0 to 24 h (AUCtau). 
Luteinizing hormone, follicle-stimulating hormone, and progesterone 
concentrations were evaluated as pharmacodynamic markers.
RESULTS: Erenumab did not influence the pharmacokinetics of norelgestromin, 
norgestrel, or ethinyl estradiol. Least-squares mean estimates (90% confidence 
interval) for Cmax ratios were 1.05 (0.90-1.23), 1.06 (0.97-1.16), and 1.04 
(0.88-1.22) for norelgestromin, norgestrel, and ethinyl estradiol, respectively. 
Respective AUCtau ratios were 1.02 (0.94-1.12), 1.03 (0.96-1.10), and 1.02 
(0.91-1.14). Luteinizing hormone, follicle-stimulating hormone, and progesterone 
concentrations were similar after exposure to oral contraceptive alone and with 
erenumab.
CONCLUSION: Erenumab did not alter the pharmacokinetics of the active components 
of an estrogen/progestin combination oral contraceptive. Thus, no change in 
contraceptive efficacy is expected with erenumab.
TRIAL REGISTRATION: ClinicalTrials.gov NCT02792517.