Botox (Botulinum Toxin Type A)

Botox is a medication prescribed in small doses to treat:

• The temporary smoothing of facial wrinkles
• Severe sweating
• Cervical dystonia (a neurological disorder that causes severe neck and shoulder muscle contractions)
• Blepharospasm (uncontrollable blinking)
• Strabismus (misaligned eyes)
• Chronic migraine
• Overactive bladder

Botox belongs to the drug class neurotoxins. This medication works by weakening or paralyzing certain muscles or by blocking certain nerves.

Botox is not recommended:

• If you are allergic or have had an allergic reaction to Botox or ingredients in Botox
• If you are pregnant or breastfeeding
• If you are allergic to cow’s milk protein

What are the Indications for Botox?

Botox is approved to use for therapeutic and cosmetic purposes, such as chronic migraine, spastic disorders, cervical dystonia, and an overactive bladder.

Botox will not cure your condition, and your symptoms will gradually return as the medication wears off.

How is Botox used?

Storage

Botox vials can be stored in a refrigerator between 35°F and 46°F (2°C to 8°C) for up to 24 months.

Keep out of reach of children.

Instructions

This medication must be injected by an experienced healthcare professional into the affected muscle. For example, when it is used to prevent migraines, it will be injected into the muscles of the head and neck, and for an overactive bladder, it will be injected into the bladder.

Dosage

Your dose, the number of injections, the site of injections, and how often you receive the medication will be determined by your condition and your response to therapy. For children, the dose is based on weight.

You should start seeing an improvement in your symptoms after one to three days. The effects last about three to twelve months, depending on the condition you are treating.

Side Effects

It’s important to understand that although Botox is FDA-approved, it comes with side effects that may or may not affect you.

Before starting Botox, you should discuss possible side effects with your doctor or pharmacist.

Common Side Effects

Not all side effects require medical attention. As your body adjusts to Botox, side effects may go away. Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own.\

• Pain/swelling/bruising at the injection site
• Flu-like symptoms
• Headache
• Upset stomach
• Temporary drooping of eyelids (if injected in the face)

Serious Side Effects

Severe adverse reactions while taking Botox may occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:

• Allergic reaction: rash, hives itching/swelling, especially the face, tongue and throat, severe dizziness, and trouble breathing.
• Serious eye symptoms: sudden vision loss, blurred vision, tunnel vision, eye pain/swelling, seeing halos around lights.
• Heart symptoms: fast/irregular/pounding heartbeat, fluttering in the chest, shortness of breath, sudden dizziness or light-headedness, fainting.

The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.

Warnings & Precautions

Before using Botox, tell your doctor or pharmacist:

• If you are allergic to Botox or any ingredients in Botox
• If you are pregnant or plan to become pregnant
• If you are breastfeeding or plan to breastfeed
• If you suffer from any eye condition, bleeding problems, heart disease, diabetes, urinary tract infection, bladder condition, muscle/nerve disorders, breathing problems, or seizures.

Clostridium botulinum

Botox is a drug made from a toxin produced by the bacterium clostridium botulinum. It’s the same toxin that can cause a life-threatening type of food poisoning called botulism.

Spreading through the body

The toxins in Botox can spread to other areas in the body from the injection site and can cause serious life-threatening side effects, such as:

• loss of bladder control, pain/burning urinating
• hoarse voice, trouble talking/swallowing
• drooping eyelids/eyebrows
• vision changes
• heart issues
• sore throat, cough, chest tightness, shortness of breath
• eyelid swelling, crusting or drainage from your eyes, problems with vision.

Pregnant or Planning to Become Pregnant

It has not been determined if Botox is safe to use while pregnant. Speak to your doctor if you are pregnant or planning to become pregnant before you receive Botox injections, because the toxins may spread beyond the original injection site.

Breastfeeding or Planning to Breastfeed

It has not been determined if Botox is safe to use while breastfeeding. Speak to your doctor if you are breastfeeding or plan to start breastfeeding.

Interactions & Contraindications

Before using Botox, tell your doctor or pharmacist if you take any medications, herbal supplements, or vitamins, and your medical history. Also let them know if you received treatment with any botulinum toxin product, especially in the last 4 months.

Do not get a Botox injection if you have an infection at the proposed injection site.

Allergy to cow’s milk

Cow’s milk protein (albumin) is used to make Botox. If you are allergic to cow’s milk protein, you should not go for Botox injections.