Autonomic dysreflexia in patients treated for overactive bladder due to neurologic disease. Autonomic dysreflexia associated with intradetrusor injections of BOTOX® could occur in patients treated for detrusor overactivity associated with a neurologic condition and may require prompt medical therapy. In clinical trials, the incidence of autonomic dysreflexia was greater in patients treated with BOTOX® 200 Units compared with placebo (1.5% versus 0.4%, respectively).


“I don’t think it is physically addictive,” says Dr. Matarasso. “But, I have to be very frank with you, when I get a new patient I tell them (and I say this tongue-in-cheek) this product is truly addictive. I make jokes with my patients that we need a 12-step program for it, because when it’s done correctly, it’s a very simple office procedure, with impressive cosmetic results.”
Jump up ^ van Ermengem E (1979). "Classics in infectious diseases. A new anaerobic bacillus and its relation to botulism. E. van Ermengem. Originally published as "Ueber einen neuen anaëroben Bacillus und seine Beziehungen zum Botulismus" in Zeitschrift für Hygiene und Infektionskrankheiten 26: 1–56, 1897". Reviews of Infectious Diseases (in German). 1 (4): 701–19. PMID 399378. Original doi:10.1007/BF02220526
Many people who experience excessive sweating, whether on their hands, hairline, or even under their breasts or butt, are turning to Botox and other neuromodulators (like Xeomin or Dysport). "They help prevent excessive sweating by acting on the sweat glands directly," says NYC board-certified plastic surgeon Z. Paul Lorenc, MD. "The neuromodulator is injected into the sweat glands to relax the muscle and help combat excessive sweating."

The Botox used for migraines and the Botox used for cosmetic procedures is actually exactly the same. "Basically, young and middle-aged women were getting [Botox] for cosmetic purposes, and that’s the most common person that has migraines, and that’s how they figured out it was helpful," Ravitz tells me. Women were getting Botox for aesthetic reasons and happened to notice relief from their migraine symptoms, and doctors began looking into it as a direct treatment. In fact, women are disproportionately affected by migraines — about 85 percent of chronic-migraine sufferers are women, and the condition affects 28 million in just the U.S.


The company markets brand products in six therapeutic areas: aesthetics/dermatology/plastic surgery; neurosciences/CNS; eye care; women’s health and urology; GI and cystic fibrosis; and cardiovascular disease and infectious disease. The company's products include Botox (botulinum toxin), Namenda (memantine), Restasis (ciclosporin), Linzess (linaclotide), Bystolic (nebivolol), Juvederm (injectable filler), Latisse (bimatoprost), Lo Loestrin Fe, Estrace (estradiol), Teflaro (ceftaroline fosamil), Dalvance (dalbavancin, Ozurdex (dexamethasone), Optive, Natrelle, Viibryd (vilazodone), Liletta (levonorgestrel), Saphris (asenapine), Enablex (darifenacin), Actonel (risedronic acid), Androderm (testosterone), and Gelnique (oxybutynin).[1]
Last time I went in for my Botox treatment, my doctor asked me if I wanted to try Aimovig. Amgen and Novartis, the two manufacturers, were offering two free injections before I could access the drug through my health insurance. I declined. I didn’t want to start a new treatment that I’ll likely be booted from in a few months because of how expensive it is. Plus, the Botox is working great. I just wish I could have gotten it when I first went to see a migraine specialist, two and half years ago.
I asked this question as Ravitz was putting the first needles in my face, which was probably a mistake as I get anxious easily. However, she assured me that the side effects of Botox typically don't happen at the doses prescribed for migraines, and even if the scary-sounding side effects you read about online do occur (such as one-side paralysis and eye droops), they aren't particularly dangerous and last four to six weeks.
When BOTOX (4, 8, or 16 Units/kg) was administered intramuscularly to pregnant mice or rats two times during the period of organogenesis (on gestation days 5 and 13), reductions in fetal body weight and decreased fetal skeletal ossification were ob served at the two highest doses. The no-effect dose for developmental toxicity in these studies (4 Units/kg) is approximately equal to the human dose of 400 Units, on a body weight basis (Units/kg).
"As we get older, we lose volume in our face and hyaluronic acid filler can be used as a replacement,” explains Wexler. "For younger women, injections can be used to treat areas with acne scarring or hollowness under the eyes." During your ‘20s, when the face is at its fullest and healthiest, it has been argued that a shadowy gaze can even be quite charming. But in other cases, hereditary dark circles can result in a persistently tired look, which is where a few drops of filler under the eyes may be useful. As top dermatologist David Colbert, M.D. is quick to note, however, too much Botox and filler distorts the face and as a result will make you appear older. “When the line is crossed everyone starts looking like they are related," he also cautions of a uniform cookie-cutter appearance that lacks character or individuality. Or worse. “It’s a snowball effect of people liking something, coming back too soon [for even more], and then it gets too heavy,” adds Wexler.
"As we get older, we lose volume in our face and hyaluronic acid filler can be used as a replacement,” explains Wexler. "For younger women, injections can be used to treat areas with acne scarring or hollowness under the eyes." During your ‘20s, when the face is at its fullest and healthiest, it has been argued that a shadowy gaze can even be quite charming. But in other cases, hereditary dark circles can result in a persistently tired look, which is where a few drops of filler under the eyes may be useful. As top dermatologist David Colbert, M.D. is quick to note, however, too much Botox and filler distorts the face and as a result will make you appear older. “When the line is crossed everyone starts looking like they are related," he also cautions of a uniform cookie-cutter appearance that lacks character or individuality. Or worse. “It’s a snowball effect of people liking something, coming back too soon [for even more], and then it gets too heavy,” adds Wexler.
Marrying ophthalmology to dermatology, Jean and Alistair Carruthers observed that blepharospasm patients who received injections around the eyes and upper face also enjoyed diminished facial glabellar lines (“frown lines” between the eyebrows), thereby initiating the highly-popular cosmetic use of the toxin.[52] Brin, and a group at Columbia University under Monte Keen made similar reports.[53] In 2002, following clinical trials, the FDA approved Botox Cosmetic, botulinum A toxin to temporarily improve the appearance of moderate-to-severe glabellar lines.[54] The FDA approved a fully in vitro assay for use in the stability and potency testing of Botox in response to increasing public concern that LD50 testing was required for each batch sold in the market.[55][56]
Tell your doctor if you received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic injection; take muscle relaxants; take allergy or cold medicines; take sleep medicine; take aspirin-like products or blood thinners.
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University-based ophthalmologists in the USA and Canada further refined the use of botulinum toxin as a therapeutic agent. By 1985, a scientific protocol of injection sites and dosage had been empirically determined for treatment of blepharospasm and strabismus.[76] Side effects in treatment of this condition were deemed to be rare, mild and treatable.[77] The beneficial effects of the injection lasted only 4–6 months. Thus, blepharospasm patients required re-injection two or three times a year.


Results can vary depending on who is performing the injection on the patient. It is very important to go to a physician who is experienced at this procedure, does it him- or herself (rather than having a nurse, physician's assistant [PA], or other nonphysician do it), and has a good reputation for performing this type of procedure. The manufacturers of Botox recommend physicians inject the medication themselves. As with most procedures, the skill of the practitioner is related to how often he or she performs the procedure.

Cornea problems have been reported. Cornea (surface of the eye) problems have been reported in some people receiving BOTOX® for their blepharospasm, especially in people with certain nerve disorders. BOTOX® may cause the eyelids to blink less, which could lead to the surface of the eye being exposed to air more than is usual. Tell your doctor if you experience any problems with your eyes while receiving BOTOX®. Your doctor may treat your eyes with drops, ointments, contact lenses, or with an eye patch.
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