Are migraine injections safe?

Question

Hello doctor,

I am a 36-year-old female. I get severe migraines three to four times a month that do not respond well to tablets. I recently heard about migraine injections that can prevent or stop attacks. The headaches last for hours and sometimes keep me bedridden, affecting my job and family life. Could you explain how these injections work and if they are safe? How often would I need to get these injections? Are they more effective than oral medicines? Do they have long-term side effects?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Migraines like yours, which are frequent and disabling, can indeed be treated with injections. Let me explain clearly:

1. How injections work:

There are two main types:

Preventive injections (e.g., Botox every three months, or newer CGRP (calcitonin gene-related peptide) monoclonal antibodies like Erenumab, Fremanezumab, and Galcanezumab). These calm down the overactive pain pathways in the brain, reducing the frequency and severity of attacks.
Rescue injections (e.g., Sumatriptan injection) that can stop an ongoing severe attack quickly when tablets fail.

2. Frequency:

Botox: Given once every 12 weeks by a trained doctor.
CGRP antibodies: Usually once a month (some are every three months).
Rescue triptan injections: Used only during an attack, not regularly.

3. Injections versus tablets:

For patients with frequent and disabling migraines, injections often work better than oral preventive medicines, and side effects are fewer. Many people who fail tablets find significant relief with Botox or CGRP injections.

4. Safety and side effects:

Generally safe with minimal long-term problems.
Botox may cause mild neck pain or temporary weakness in neck muscles.
CGRP antibodies may cause mild injection site redness, constipation, or, rarely, allergic reactions.

They do not usually affect organs like the liver, kidney, or heart, which makes them safer long-term compared to some oral drugs.

I hope this information will help you.

Thanks.