FAQ

Botox Treatment for Migraines

BOTOX® is the first Health Canada approved and FDA approved preventive treatment for Chronic Migraine. Unlike acute treatments, which are taken to treat a headache or migraine once it‘s already begun, BOTOX® prevents headaches and migraines before they even start.
BOTOX® prevents on average 8 to 9 headache days and migraine/probable migraine days a month (vs 6 to 7 for placebo).

5 quick things you should know about BOTOX® treatment

A chronic migraine is a neurological condition that is defined by having 15 or more headache days per month, with each headache lasting 4 hours or more, and eight of those days associated with a migraine.

Frequent or re-occurring migraines may often be referred to as chronic, or “chronic migraines.”  However, a chronic migraine is different. It is a medical condition that involves 15 or more headache days per month, with each headache lasting 4 hours or more, and 8 of those days associated with migraine.

An estimated 8.3% of Canadians (2.7 million) reported that they had been diagnosed with migraine. Research indicates that this likely underestimate the true number of people in Canada living with migraine pain.

The difference between an episodic migraine (EM) and chronic migraine (CM) is how frequently the migraines occur. Your doctor may diagnose you with episodic migraines if you have fewer than 14 headache days per month for 3 months. Chronic migraine sufferers experience 15 headache days or more per month and experience higher social and professional burden because they are significantly more disabled than those with episodic migraines. Most people with chronic migraines begin with an episodic migraine. You may experience an episodic migraine if you go weeks or months between migraine attacks.

Characteristics of chronic migraines

Your doctor might diagnose you with an episodic migraine if you have:

  • 14 headache days for 3 months
  • Headaches that last less than 24 hours
  • At least 5 migraine attacks in your lifetime

People who progress from episodic migraines to chronic migraines, the frequency and severity of their headaches and migraines get worse over time. There is less and less recovery time in between. People may go from a few headache days a month to one every few days. Eventually, they get to the point where they have 15 or more headache days a month, with each headache lasting 4 hours or more, and 8 of those days associated with migraine-otherwise known as a chronic migraine.

The HMC Centre doctors are specifically trained to treat chronic migraines. Our doctors work with a team of specialist to develop a comprehensive treatment plan to help you recover from headache migraine pain so you can start living again.

BOTOX® Treatment

BOTOX® is part of a group of drugs known as biologics–biologic medicines are made from living things. BOTOX® is a purified protein that is made from a type of bacteria called Clostridium botulinumtype A.

BOTOX® is injected to prevent headaches in adults with Chronic Migraine who have 15 or more headache days each month with headache lasting 4 hours or more each day in people 18 years or older.
lt is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine). ln clinical trials, BOTOX® provided a significant reduction in headache days after the first treatment. After the second treatment (at 24 weeks), BOTOX® prevented 8 to 9 headache days a month (vs 6 to 7 for placebo). You may start to feel results as early as 4 weeks. Over the course of 2 treatment sessions, you should notice a reduction in headache days.

The needle used to inject BOTOX® is half an inch long and very thin. The injections take about 15 minutes, and though you may experience mild discomfort, people say the injection feel like pinches or pinpricks.

BOTOX® injections are given every 12 weeks by your doctor. For 2 treatments (at 24 weeks), BOTOX® was proven to reduce headache days each
month vs placebo. ln clinical studies, BOTOX® prevented on average 9 headache days a month (vs 7 for placebo).
Based on your progress, you and your doctor will discuss re-treatment every 12 weeks.

In clinical trials, BOTOX® provided a significant reduction in headache days after the first treatment. After the second treatment (at 24 weeks),
BOTOX® prevented up to 9 headache days a month (vs up to 7 for placebo). You may start to feel results as early as 4 weeks. Over the course of 2 treatment sessions, you should notice a reduction in headache days.

if your doctor recommends it, you may still take acute medications while you are on BOTOX® treatment. BOTOX® is a preventive treatment-which means it works to prevent headache days. Acute treatments, on the other hand, are taken to reduce pain once a headache or migraine has already begun.

The injection sites for Chronic Migraine are specifically designed to help prevent headaches and migraines.
BOTOX® is for adults with Chronic Migraine with 15 or more headache days a month, each lasting 4 hours or more. BOTOX® therapy is not approved for adults with migraine who have 14 or fewer headache days a month.

Our clinic has 2 physicians, each with at least 10 years of injecting experience using BOTOX® for prevention of migraines.

IMPORTANT SAFETY INFORMATION
BOTOX® may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX?

  • Problems swallowing speaking or breathing due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months.
  • Spread of toxin affects The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing.

There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX® has been used at the recommended dose to treat chronic migraine.

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

Do not take BOTOX® if you: are allergic to any of the ingredients in BOTOX® (see Medication Guide for ingredients); had an allergic reaction to any
other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.

The dose of BOTOX® is not the same as, or comparable to, another botulinum toxin product:

Serious and/or immediate allergic reactions have been reported. They include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness
or feeling faint. Get medical help right away if you experience symptoms; further injection of BOTOX® should be discontinued.

Tell your doctor about all your muscle or nerve conditions such as ALS or Lou Gehrig’s disease, myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of BOTOX®.

Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles; trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® can harm your unborn baby); are breastfeeding or plan to (it is not known if BOTOX® passes into breast milk).

Tell your doctor about all the medicine you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® 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.

Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such
as Myobloc®, Dysport‘fi’, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-Iike products or blood thinners.

Gather side effects of BOTOX® include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

For more information refer to the Medication Guide or talk with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Indication
BOTOX® is a prescription medicine that is injected to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.
It is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).
Please see BOTOX® full Product Information including Boxed Warning and Medication Guide.

Will my insurance cover BOTOX®?
Most insurance plans cover the majority of the cost of BOTOX®.

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