David W. Stepnick, MD

Botox binds to "acceptor sites" on motor nerve terminals, enters the terminals, then blocks release of the substance that triggers a muscle to contract. Once this has happened, the effect of Botox lasts, on the average, for several months. But, the Botox is not "floating around" in the bloodstream during this period of time.

Pharmaceuticals and and their relationship to "pregnancy" is always a "tricky" issue, because nobody (doctor or patient) wants harm done to a fetus. And, one cannot risk that a pharmaceutical might do damage to a fetus. So, many drugs, including Botox, are not recommended during pregnancy.

Theoretically, within hours or a few days after one has had Botox treatment, the material has been "absorbed" into the nerve terminals and is not available to sites elsewhere in the body. If the Botox is not available elsewhere in the body, it would not damage a fetus.

In your case, it has been almost two months since you've had Botox, so the risk should be pretty close to zero, if not zero. But, there is always the person who will have a child that has suffered some unrelated intrauterine insult who "blames" a certain event or drug for the problem when, in fact, the event or drug had nothing to do with it.

While I personally would tell a family member that it's safe to get pregnant 8 weeks after having received Botox, or to want to be even safer, to wait until the effects of the Botox have completely worn off, I am not sure it's smart for me to offer you that advice in a public forum like this.

Please review the information (below) taken from Allergan's package insert on Botox Cosmetic as you make your final decision, and if you want advice specific to you, ask the physician who did the Botox treatment! You paid for his or her expertise, not just a technical fee for Botox injections.

Pregnancy: Pregnancy Category C
Administration of BOTOX® Cosmetic is not recommended during pregnancy. There are no adequate and well-controlled studies of BOTOX® Cosmetic in pregnant women. When pregnant mice and rats were injected intramuscularly during the period of organogenesis, the developmental NOEL (No Observed Effect Level) of BOTOX® Cosmetic was 4 U/kg. Higher doses (8 or 16 U/kg) were associated with reductions in fetal body weights and/or delayed ossification.

In a range finding study in rabbits, daily injection of 0.125 U/kg/day (days 6 to 18 of gestation) and 2 U/kg (days 6 and 13 of gestation) produced severe maternal toxicity, abortions and/or fetal malformations. Higher doses resulted in death of the dams. The rabbit appears to be a very sensitive species to BOTOX® Cosmetic.
If the patient becomes pregnant after the administration of this drug, the patient should be apprised of the potential risks, including abortion or fetal malformations that have been observed in rabbits.
 

Carcinogenesis, Mutagenesis, Impairment of Fertility:
Long term studies in animals have not been performed to evaluate carcinogenic potential of BOTOX® Cosmetic. The reproductive NOEL following intramuscular injection of 0, 4, 8, and 16 U/kg was 4 U/kg in male rats and 8 U/kg in female rats. Higher doses were associated with dose-dependent reductions in fertility in male rats (where limb weakness resulted in the inability to mate), and testicular atrophy or an altered estrous cycle in female rats. There were no adverse effects on the
viability of the embryos.
 

Nursing mothers:
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when BOTOX® Cosmetic is administered to a nursing woman.