Uses
What is Botox Cosmetic used for?
Botox Cosmetic (onabotulinumtoxinA) is commonly used to temporarily improve the look of moderate to severe frown lines between the eyebrows (glabellar lines), crow’s feet lines (lateral canthal lines), or forehead lines.
For information on Botox for noncosmetic uses, see Botox.
Botox Cosmetic may also be used for other conditions as determined by your healthcare provider.
How does Botox Cosmetic work (mechanism of action)?
Botox Cosmetic works beneath your skin by blocking certain nerve signals and reducing activity in the muscles of your face. This muscle activity causes the appearance of wrinkles and lines, such as frown lines, crow’s feet lines, and forehead lines. By reducing the muscle activity of your face, Botox Cosmetic temporarily makes lines on your face look better.
How is Botox Cosmetic supplied (dosage forms)?
Botox is available as an injection that is given by a healthcare provider.
How should I store Botox Cosmetic?
Botox Cosmetic is usually given by a healthcare provider in a hospital or clinic. If you will store Botox Cosmetic at home, follow the instructions given by your healthcare provider.
Side Effects
What are the most common side effects of Botox Cosmetic?
The most common side effects of Botox Cosmetic are listed below. These side effects may vary depending on where you receive your injection. Tell your healthcare provider if you have any of these side effects that bother you.
- Discomfort or pain at the injection site
- Drooping eyelids
- Puffy eyelids
- Headache
- Drooping eyebrows
There may be other side effects of Botox Cosmetic that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Botox Cosmetic?
While less common, the most serious side effects of Botox Cosmetic are described below, along with what to do if they happen.
Severe Allergic Reactions. Botox Cosmetic may cause allergic reactions, which can be serious. Stop using Botox Cosmetic and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Breathing, Swallowing, or Speaking Problems. Botox Cosmetic may cause problems with breathing, swallowing, or speaking. This can be serious or life-threatening. This is caused if the muscles you use to breathe and swallow become weak after the injection. It can happen hours, days, or weeks after your dose. Swallowing difficulties can last for several months. People who have trouble swallowing may need a feeding tube to get food and water. If swallowing issues are severe, food or liquids could enter your lungs. Get emergency medical help right away if you have trouble breathing, swallowing, or speaking.
Spread of Toxin Effects. The medicine in Botox Cosmetic may affect areas of your body away from the injection site. This may cause symptoms of a serious condition called botulism. Symptoms of botulism can start within hours, days, or weeks after your dose. Contact your healthcare provider right away if you have any of the following symptoms of botulism.
- Loss of muscle strength or muscle weakness all over your body
- Double vision, blurred vision, and drooping eyelids
- Losing your voice or voice changes, such as hoarseness
- Trouble saying words clearly
- Loss of bladder control
- Trouble breathing or swallowing
Heart Effects. Botox Cosmetic may increase your risk of certain effects on the heart, such as causing an abnormal heart rhythm (arrhythmia) or a heart attack, which could lead to death. Get emergency help if you have chest pain or pressure, trouble breathing, or if you have a change in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat.
Eye Dryness. Botox Cosmetic may cause dry eyes if it is injected near your eyes. Tell your healthcare provider if you have any of the following symptoms of eye dryness.
- Eye pain or irritation
- Eyes sensitive to light
- Changes in your vision
Warnings & Precautions
Who should not use Botox Cosmetic?
Allergies to Ingredients. People who are allergic to any of the following should not use Botox Cosmetic.
- OnabotulinumtoxinA
- Botox or Botox Cosmetic
- Other botulinum toxins, such as rimabotulinumtoxinB (Myobloc), abobotulinumtoxinA (Dysport), or incobotulinumtoxinA (Xeomin)
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Botox Cosmetic.
Skin Infection. Botox Cosmetic should not be injected into skin that is infected. Tell your healthcare provider if you have any symptoms of skin infection, such as redness, pain, swelling, warm skin, or blisters.
What should I know about Botox Cosmetic before using it?
Do not use Botox Cosmetic unless it has been prescribed by a healthcare provider. Your healthcare provider will store and give you the medicine.
Botox Cosmetic may cause loss of strength, muscle weakness, vision problems, or dizziness. This may happen within hours, days, or weeks after an injection of Botox Cosmetic. Do not drive or do other activities that require alertness or coordination until you know how Botox Cosmetic affects you.
What should I tell my healthcare provider before using Botox Cosmetic?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Botox Cosmetic is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Muscle or nerve disorders, such as amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease, myasthenia gravis, or Lambert-Eaton syndrome
- Breathing problems, such as asthma or emphysema
- Swallowing problems
- Bleeding problems
- Plans to have surgery
- Past surgery on your face
- Weakness of your forehead muscles, such as trouble raising your eyebrows
- Drooping eyelids
- Changes in the way your face normally looks
- Urinary tract infection symptoms, such as pain or burning when you pee, frequent peeing, or fever
- Inability to empty your bladder (urinary retention)
- Heart problems, including heart disease
Other Medicines and Supplements. Botox Cosmetic may interact with other medicines and supplements. Before receiving Botox, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how Botox Cosmetic could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if Botox Cosmetic passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should receive Botox Cosmetic while breastfeeding.
How can I get more information about Botox Cosmetic?
For more information about Botox Cosmetic, you can visit the manufacturer’s website at www.botoxcosmetic.com or call them at 800‑377‑7790.
Interactions
Does Botox Cosmetic interact with foods or drinks?
There are no known interactions between Botox Cosmetic and foods or drinks.
It is unknown if drinking alcohol will affect Botox Cosmetic. If you have dizziness or blurred vision from Botox Cosmetic, alcohol may worsen these effects.
Does Botox Cosmetic interact with other medicines (drug interactions)?
Botox Cosmetic interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using or have used any of the following before using Botox Cosmetic.
- Any other botulinum toxin product, such as rimabotulinumtoxinB (Myobloc), abobotulinumtoxinA (Dysport), or incobotulinumtoxinA (Xeomin)
- Any aminoglycoside antibiotic, such as amikacin or gentamicin, which is given by injection to treat infections
- A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine (Amrix), or tizanidine (Zanaflex)
- An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- A sleep medicine, such as temazepam (Restoril), zolpidem (Ambien and others), or eszopiclone (Lunesta)
- Aspirin, which is in many prescription and OTC products including those for pain, swelling, and fever
- An antiplatelet medicine, such as clopidogrel (Plavix), ticagrelor (Brilinta), aspirin/dipyridamole, or cilostazol, which is a medicine used to prevent blood clots
- A blood thinner, which is a medicine used to treat or prevent blood clots
This may not be a complete list of medicines that can interact with Botox Cosmetic. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Botox Cosmetic?
If you or someone else has used too much Botox Cosmetic, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Botox Cosmetic?
Botox Cosmetic is usually given by a healthcare provider in a clinic. Your healthcare provider will make sure you are receiving Botox Cosmetic as scheduled.
If you miss an appointment to get your Botox Cosmetic dose, call to make another appointment as soon as possible.