First thought here is that BOTOX is to be given by a CERTIFIED Neurologist who understands how to give it, when to give it and where to administer it. The patient who is to be given this med must qualify for it by diagnosis, symptoms, length of time, other treatments used to treat the headaches and when the type of migraine was given to the patient. The 30+ shots are given every three months on a schedule per FDA regulations, policy /procedure since you must sign your signature to receive this medication. The usual dosage is around 200 mg divided up between different sites of your forehead, neck, around your head, back of your ears, jaw and trigger points. A diary of symptoms, migraines, hours of sleep, vertigo, other medications taken or treatments are logged and given to the doctor at each MD apt for continued approval of BOTOX administration. As noted previously, the Triptans drugs are also a means to treat Migraines since they are a Step program and can be used in addition to BOTOX for breakthrough headaches.
Newer medications are on the market now to help with these break thru headaches that include injections - you as a patient give to yourself. The manufacturers have special programs that help pay for these programs if you want to participate in them since insurance does not pay for these meds, I recently signed up for one of them since I now have more migraines post COVID. Eloise

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