Botulinum Toxin

Brand Name:Botox, Botox Cosmetic

Prescription needed: Yes

What is this drug used for?

Botulinum toxin is used to treat the symptoms of muscle spasm in different parts of the body, like the eye and neck, as well as for excessive sweating disorders. It is also commonly used for cosmetic purposes.

It is made by a bacteria and is considered to be a nerve poison (neurotoxin). It works by paralyzing the nerve that is connected to a specific muscle and causing less spasm and muscle relaxation. For excessive sweating, it works by paralyzing the nerve to the sweat gland causing a decrease in sweat production.

Is there any reason not to take this drug?

You should not take botulinum toxin if you are allergic to it. This medication should be avoided or used with extreme caution in people with myasthenia gravis, Lambert-Eaton syndrome or an infection at the site where the medication will be injected. Before using this medication, tell your doctor specifically if you have or have ever had:
  • amyotrophic lateral sclerosis (Lou Gehrig's disease)
  • weakness or swelling at the site where the medication will be injected
  • any bleeding or blood clotting problems
  • any nerve problems
  • swallowing problems
  • botulism poisoning
  • surgery or procedures at or near the site of the injection
  • problems with vision
  • heart disease

What about possible side effects?

Side effects to this medication usually occur at or near the site where the medication is injected, within the first week of the injection, and tend to go away after time. These include:
  • pain, swelling or bruising at injection site
  • dry eye
  • droopy eyelid
  • feeling weak in the muscles
  • painful swallowing (this could be mild to severe)
  • decreased blinking

Less common and possibly severe side effects include (call your doctor if you notice anything below):

  • glaucoma (problems with vision)
  • allergic reaction, rash, itching
  • pain in eyes
  • tremour and/or weakness in neck or head
  • problems with breathing
  • fever, feeling like you have the flu (weak, fever, muscle aches), upper lung infections

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

There are not a lot of reported drug interactions with this medication. However, it is important that you tell all healthcare providers that you are receiving this medication as there is risk for some drug interactions, specifically some antibiotics that are given by an intravenous (IV) solution usually in the hospital.

Other information:

This medication works slowly and, depending on where the injection is being given, it can take up to 6 weeks for maximum effect. Some conditions you may see an improvement faster (within days for eyelid conditions).

To keep seeing a response to this medication, you will need to use the medication on an ongoing basis, usually every 2-3 months.

Children: Very little information on safety but it has been used in some situations. Lower dose is required.

Seniors: May take as prescribed. May be at higher risk for side effects

Pregnancy: Safety not established. Talk to your doctor.

Women who are nursing: Safety not established. Talk to your doctor.

People who drive or operate machinery: No known problems.

Overdose: If you experience any unusual reactions or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: You will likely see a return of the symptoms once the medication is stopped.

If you miss a dose: This drug is only administered by your doctor.

Storage conditions: This drug is stored in a hospital or doctor’s office.

Alcohol: No known problems. If you drink, always drink in moderation.

Dietary Precautions: None.