Migraine
Botox for migraine prevention
Botulinum toxin, migraine prevention
Other names: Botox, botulinum toxin, botulinum toxin type A, onabotulinumtoxinA
Wait
1 month
ground trial when starting
Different waits apply in other cases.
FAA label
SI CONDITIONAL
The FAA lists Botox for migraine prevention as SI-conditional, requiring a special issuance, with a one-month ground trial and 72 hours of no-fly after each dose; it notes Botox is reserved for severe refractory headaches.
Track your medicationsMore detail: Botox for migraine preventionThe rest of Crosscheck's reading, in plain wordsOpen
Wait
- 72 hours after each dose
It says Botox may cause delayed adverse effects such as muscle weakness, excessive fatigue or eye symptoms.
- 72 hours after each dose: ground observation
FAA rule for migraine medication: The FAA says migraine relief or rescue medication is acceptable when used occasionally and unacceptable for daily use, and that its post-dose observation time (no-fly warning) is based on the drug's half-life. It says that if several relief medications are needed on a recurring basis to stop symptoms, this is considered a complicated migraine, and the examiner should defer. For relief or rescue medication the worksheet lists, the FAA's CACI – Migraine and Chronic Headache Worksheet says the examiner can issue if the pilot meets all of its acceptable certification criteria, which include no more than one episode per month, no more than 2 outpatient clinic or urgent care visits for symptom exacerbation in the last 12 months (even if symptoms fully resolved), and no history of in-patient hospitalizations for headaches; it says narcotics, Fiorinal, Fioricet and Midrin are not acceptable for relief or rescue. FAA, Migraine Medication
Show the FAA's words: Botox for migraine preventionThe official FAA wording: one passage, each with its document and dateOpen
Botox is not a first-line treatment for migraines. It is reserved for individuals with severe refractory headaches.
May cause delayed adverse effects such as muscle weakness, excessive fatigue, or eye symptoms.
Requires Special issuance.
SI CONDITIONAL – Migraine Prevention (Prophylaxis)
No-Fly Time After each dose
botulinum toxin (Botox), 1 month, 72 hours