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Botox (onabotulinumtoxinA) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to prevent headaches in adults with chronic migraine.
These insights are based on 6,398 comments about Botox from MyMigraineTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.
Benefits:
Considerations:
Botox is a type of nerve-blocking medicine that works by blocking the release of a chemical messenger called acetylcholine. In chronic migraine, this helps reduce pain-related nerve signaling.
Doctors prescribe Botox when an adult has chronic migraine, meaning headaches happen on 15 or more days each month and last four hours a day or longer.
Botox is given as intramuscular injections, typically every 12 weeks. These injections are given by a healthcare professional.
The recommended dose of Botox for chronic migraine is 155 Units given by intramuscular injection, divided across 31 injection sites in seven specific head and neck muscle areas every 12 weeks. The injection sites are determined by your healthcare provider.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 6,398 comments about Botox from MyMigraineTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.
Members who use Botox often say that setting realistic expectations, keeping up with regular appointments, and staying in close touch with a neurologist or headache specialist can make treatment easier to manage. Many also mention tracking patterns like wear-off timing, side effects, and migraine changes so they can discuss them with their doctor.
Be patient. Improvement can take a few treatment cycles.
“My neurologist said that you typically don’t see effect from Botox until the 2nd to 4th dose, and you taper up to your maximum needed dose within a year.”
Keep Botox appointments on a regular 12-week schedule.
“Keeping the shots in a timely manner is important. I missed my scheduled dose as the neurologist was sick and there was no back-up plan.”
Track when Botox starts working and when it wears off.
“The relief starts to wear off about a week before I am due for the next round.”
Tell your doctor about side effects or injection problems.
“I had to stop my Botox injections because I had experienced a left droopy eye.”
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In clinical studies of Botox for the prevention of headaches in adults with chronic migraine, the most common side effects occurred in about 2 percent to 9 percent of people. They include:
Botox can cause serious side effects that may require immediate medical attention. These include:
Botox has a boxed warning, the FDA’s strongest safety warning, for some of the serious risks mentioned above. A boxed warning does not mean the drug is unsafe for everyone or that everyone faces the same level of risk.
Get medical help right away if you think you are having a serious reaction.
AbbVie, the manufacturer of Botox, offers the BOTOX Savings Program. Eligible commercially insured individuals may pay as little as $0. Individuals enrolled in Medicare, Medicaid, TRICARE, or any other government-reimbursed healthcare program are not eligible for this program.
To learn more, visit the BOTOX Savings Program website or call 800-44-BOTOX (800-442-6869).
Tell your doctor if you have any allergies to onabotulinumtoxinA or any ingredients in Botox. Do not take Botox if you are allergic to any botulinum toxin product or to any of the components in the formulation.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past.
Do not take Botox if you have an infection at the planned injection site.
Tell your doctor about all your medical conditions, including if you:
Botox may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of receiving Botox. If this happens, do not drive a car, operate machinery, or do other dangerous activities.
Botox is also FDA-approved to treat overactive bladder, urinary incontinence due to detrusor overactivity associated with a neurologic condition (including in children ages 5 and older with neurogenic detrusor overactivity), spasticity (in people ages 2 and older), cervical dystonia, severe primary axillary hyperhidrosis, and strabismus or blepharospasm (in people ages 12 and older).
If you are pregnant, planning to become pregnant, or breastfeeding while taking Botox, talk with your doctor about the risks and benefits.
These answers are fact-checked by our editorial staff.
How effective is Botox?
In two 24-week studies of adults with chronic migraine, people who received Botox had fewer headache days than those who received a placebo (an inactive treatment). This means Botox can help reduce how often headaches happen.
How long does Botox take to work for migraine?
Botox is given every 12 weeks to help prevent chronic migraine headaches. It may take some time to see improvement, but the exact time can be different for each person.
Can Botox cause neck pain or drooping eyelids when used for migraine?
Yes. In clinical trials for chronic migraine, neck pain was reported in 9 percent of people taking Botox, and eyelid drooping was reported in 4 percent.
On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.
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