- In this Article
- Risks and benefits
Risks and benefits
What are the risks with botulinum toxin?
Serious, although uncommon, reactions have occurred when the toxin has spread from the injection site to other muscles, resulting in general weakness, the need for a respirator, and in rare cases, death.
Case studies have described another side effect, though rare: muscles losing their tone from injections around the temple area, resulting in an "hourglass" deformity.
Predictable side effects include pain and bruising at the injection site, temporary weakness of the injected muscle, headache, nausea, neck or back pain, dry mouth, and dry or irritated eyes.
What precautions can you take?
Seek treatment from a specialist for your condition-such as a board-certified dermatologist or neurologist-and ask about their experience with the toxin. "This treatment requires skill, training, and knowledge of the patient's disease," Simpson warns. "Be cautious if it's offered at a spa or Botox party, or by a family doctor who does it on the side."
Tell your doctor if you have heart disease or a disease in which communication between nerve and muscle is damaged, such as ALS or myasthenia gravis. You may be oversensitive to the toxin's side effects.
Tell your doctor what medications and dietary supplements you take or plan to take. Be sure to mention antibiotics, drugs for Alzheimer's disease, or any other botulinum toxin treatment you've had during the last four months.
He or she should not inject the medication into an infected area, so be sure to point out swelling or other signs of infection.
And, tell your doctor if you are pregnant, trying to become pregnant, or if you are nursing.
Other precautions:
Seek immediate medical attention if you develop any of the following symptoms within hours or weeks after treatment: muscle weakness or unexpected loss of strength, hoarseness or difficulty talking, trouble saying words clearly, the loss of bladder control, difficulty breathing or swallowing, double or blurred vision, or drooping eyelids.
Bottom line:
Botulinum toxin is widely used off-label, usually without serious complications. Our advice: Consider the injections for the above treatments only after you've talked with your doctor about other treatments options for your condition and only after the risks and benefits of botulinum toxin have been thoroughly explained to you.
This off-label drug use report is made possible through collaboration between Consumer Reports Best Buy Drugs and the American Society of Health-System Pharmacists. This is the fourth in a series based on professional reports prepared by ASHP.
These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin)
