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Two needles with boxing gloves on the plunger end.

Botox and Ajovy; A One-Two Punch

I received my first Botox injections in June of 2018 after jumping through all kinds of hoops to get it approved. I had no expectations for the first round of shots partly because it has been a challenge to treat my chronic, intractable migraine. I was optimistic and as ever hopeful. In December of 2018, I received my first dose of the CGRP drug Ajovy. I was more excited about Ajovy than Botox, and I prayed I would not be in the twenty percent group of people that the drug did not work effectively. I was happy to find out that with a copay card the Ajovy shots would be free to fill!

Botox injections eased some of my migraine symptoms

To break down my experience with Botox and Ajovy I’m going to start with Botox since that was the beginning of this journey. As I said I have been suffering from chronic, intractable migraine for months and I was desperate for some relief from the unrelenting cycle of migraine. The injections were really easy to take as the neurologist administered them. There was a slight pinching sensation I felt as he did the injections around my scalp and forehead. I didn’t feel the injections in my neck and shoulders at all, but I will warn you about getting the injections during a migraine attack.

I did this once and the pain was beyond excruciating. I was out for the entire day with ice packs strapped to my head hiding in my darkened room as I tried to ride out the intense attack the injections brought on. I continued getting the shots every three months. I did notice improvement of my neck pain, as well as the fatigue across my shoulders, had improved thanks to Botox. My headaches, however, refused to relent.

Receiving my first Ajovy shot

I received my first Ajovy shot from the neurologist in December of 2018. I was happy to have it but also felt a bit nervous. I wondered what I would experience. Would I see awesome results or would this just become another failed therapy for me? I wasted no time and immediately gave myself the injection after returning home from the appointment. It was relatively painless and I had no adverse reactions that I could see.

Head pain intensity improving after the CGRP injection

It was about five days after the injection that I noticed my headache pain intensity was starting to diffuse. It was like dropping a drop of food coloring into a glass of water. The pain wasn’t as potent any longer. I breathed a sigh of relief. Over the next four months of injections, I noticed a bit more improvement with the pain intensity. Unfortunately, most of the other baggage from migraine hung on like allodynia, aphasia, tinnitus, and insomnia. That being said I would have done this again knowing what I know now. The relief in the pain was worth getting the shot. I still have bad days, but they are more easy to manage now and I’m grateful for that!

Insurance barries with Botox and Ajovy

Botox and Ajovy together worked well in my opinion. I don’t know if any of the other CGRP drugs such as Emgality or Aimovig would have yielded the same results, but I’d be interested to know. I felt very fortunate to have been able to use the combined therapy of Botox and Ajovy. I had to discontinue both in May of 2019 due to a lapse in our insurance benefits, but as of September 2019, I am still enjoying the reduced pain from my attacks. I do plan on trying to get back to Ajovy and Botox now that our insurance issues have been resolved.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • gheyer
    1 week ago

    I am 3 weeks in, from my first Botox treatment. I had tried Aimovig, and at first had no migraines at all. However, by the 7th month, they came back with a vengeance. The Dr then had me try Emgality. I received no relief that first month, but the Dr had already scheduled me to see a neurologist, who then just started me on the Botox.
    I’m really concerned about the neck weakness, and difficulty swallowing. I can’t bend forward at all, because I can’t support my head enough. Even when eating, I have to raise my plate closer to my mouth, so I don’t have to lean forward.
    I know they say that you can experience this, but how long should I expect it to last?
    I did start having some migraine pain, but aspirin powders cleared it for most part.
    I have not heard of Ajovy. Is it very similiar to Aimovig and Emgality? If you’re didn’t help, is there a chance that Ajovy might?

  • Tom Picerno moderator author
    5 days ago

    @gheyer I’m not sure how long the weakness effects of your Botox shots will last. Make sure to cover that with your administering doctor. Ajovy is similar to Emgality and is another CGRP injectable. I had good, lasting results from Ajovy. My las shot was six months ago and I still have relatively low pain days. I do still experience the prodrome and postdrome effects of migraine just with less head pain. Ill take that as a win! I hope you have similar luck with your treatments. Tom (migraine.com team)

  • sunnynights68
    1 week ago

    I just started the emgality on August 30th. I have been doing the botox for a year and it worked at first but in July I was up to every other day migraines. I ended up in the ER with a really bad one when my neuro decided to try the emgality. I felt an almost instant relief and by the second day I felt amazing. I think I’ve had maybe one real migraine in the past 6 weeks and I’m thrilled. I do get tiny little pressure days like I’m going to get one but it subsides now without any abortive measures. I pray this trend continues because I’ve tried everything in the past with no luck. I agree with the other comment about watching your food intake. For me, I avoid dairy.

  • Tom Picerno moderator author
    5 days ago

    @sunnynights68 I’m happy to hear that you’ve had such a good experience with Emgality. Are you still receiving Botox injections as well or did you decide to discontinue them? Enjoy all your migraine free days! It is important to celebrate your wins with this disease. Tom(migraine.com team)

  • Tom Picerno moderator author
    4 days ago

    @sunnynights68 best of luck with the two treatment plan. I pray it works exceptionally well and gives you back what migraine has taken from you! Tom( migraine.com team)

  • sunnynights68
    5 days ago

    Yes to the Botox, my neurologist wants to continue because she thinks it’s a 2 treatment success plan. Hopefully this is the answer!

  • JoyM
    1 week ago

    I am happy to say through emgality and the savings card plus the Botox, I have gone 3 weeks without a “Migraine”. Unbelievable! Then unfortunately there was a mistake that was made through neurology office and pharmacy.Still having some trouble getting medication ..
    I hope we can all come together and get this straightened out. It’s enough to trigger migraines. Awful. Some people are pleasant and caring some just aren’t. I hope everyone is having a good day and can find some relief with the info I have shared. Zofran 4mg odt has also been great for nausea, another trigger for me. Good day!

  • Peggy Artman moderator
    1 week ago

    JoyM, it is always great to hear someone having success with a treatment! I hope your doctor and insurance will get things worked out soon so you can continue with the treatment.
    ~ Peggy (Migraine.com team)

  • BikerMiker24
    1 week ago

    Unfortunately I was one of the 20% that Ajovy wasn’t effective. I took the first shot in my neurologist’s office. I had an attack two days later, but then managed to go 6 weeks with no migraine. I thought I’d found my miracle drug. Then in the past 6 weeks I’ve had 11 migraines. I was taking Pamelor as a preventative before starting the Ajovy. My wife and I decided to see that if the Ajovy was really going to work, I needed to get off the Pamelor. So I weaned myself off, and went with just the Ajovy. Those 11 migraines all came while I was off the Pamelor. So needless to say, I’ve started back on the Pamelor with all of its side effects. I go back to my neurologist next month. I’m glad to hear Ajovy worked for you.

  • Peggy Artman moderator
    1 week ago

    BikerMiker24,
    I don’t know what it was like for you before trying Ajovy, but people can still get migraine symptoms even while on Ajovy. None of the CGRP medications promise people will never have a migraine again. There are people on this treatment that very seldom get migraine attacks again. But at this time, there is no cure for migraine. I hope you can find something that makes things better for you.
    ~ Peggy (Migraine.com team)

  • olevik
    1 week ago

    Glad it had worked for you, Botox helped me too, less sensitive to light now. Have you tried the keto diet? Helped me a lot! Many migraines were related to eating or not eating. Sugars and insulin resistance is the culprit. Keto diet eliminates fine carbohydrates so your body adapts to burning fats instead. Works on many levels

  • Kate
    2 weeks ago

    Its awesome you were able to get both Botox and Ajovy covered by insurance; I hope you can get back on them and keep the progress you’ve made. I have been hearing that some insurance companies are denying the use of both together (the prior authorization would be denied if the other med had been injected in the last 3 months), apparently on the basis that CGRPs weren’t studied in patients already receiving Botox. Sounds like they are using that as an excuse to get out of paying for 2 expensive meds at the same time. I hope insurance coverage for newer migraine preventatives improves, between devices like Cefaly & Gammacore (I haven’t heard of any insurance covering them in the U.S.) and CGRPs (seems like insurance coverage is inconsistent).

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