Key Points

• The recommended total dose of Botox (onabotulinumtoxinA) for chronic migraine prevention is 155 Units administered into a muscle (intramuscularly).
• This is given as 0.1 mL (5 Units) injections divided across 7 specific head and neck muscle areas, for a total of 31 individual injections per session. You should receive these injections from a medical specialist that is trained in Botox injections.
• The areas that are injected with Botox for migraine prevention include the forehead, bridge of the nose, the temples, the neck, the back of the head, and just above the shoulder blades in the upper back. The injections are given with a small needle and may feel like a tiny pinprick.
• Injections take about 15 minutes and you can usually go back to your normal routine afterwards.

Botox is used in adults to prevent chronic migraine headaches that occur on 15 or more days per month and that last at least 4 hours.

Infrequently Botox may cause loss of strength or general muscle weakness, vision
problems, or dizziness within hours to weeks of taking Botox. If this happens, do not drive a car, operate machinery, or do other dangerous activities

How often do I see my doctor for Botox injections for migraine?

You will usually start with 2 treatments spaced 12 weeks apart. Once you and your doctor see how you respond to Botox for migraine, you will then continue treatments every 12 weeks if it is working well for you.

The recommended retreatment schedule of Botox for migraine prevention is every 12 weeks. This means you will only need to receive injections 4 times per year or as directed by your healthcare provider.

How quick does Botox work for migraine headaches?

In studies, some patients felt headache results as soon as 4 weeks. If Botox for migraine prevention works for you, you should usually see results after the second set of injections at 12 weeks.

In 6-month long studies, patients continued to see reductions in their number of headache days on most days over the study period. Botox also lowered the total length of time of headaches on days when they occurred over the study period, when compared to placebo (an inactive treatment).

Bottom Line

• The recommended total dose of Botox (onabotulinumtoxinA) for chronic migraine prevention is 155 Units administered intramuscularly (into the muscle).
• This is given as 0.1 mL (5 Units) injections divided across 7 specific head and neck muscle areas, for a total of 31 individual injections per session. The injections feel like a small pinprick.
• Injections take about 15 minutes and you can usually go back home, to work, or on to your normal routine afterwards.

This is not all the information you need to know about Botox for safe and effective use for migraine. Review the full Botox information here, and discuss this information and any questions you have with your doctor.