Botox does not come pre mixed

Darrick E. Antell, MD answers: Does a vial of Botox come pre-mixed?

I have heard Botox has to be mixed each time it is used. Is this true, or does it come pre-mixed? Thanks.


Darrick E. Antell, MD
10 months ago

Botox is stored in a cold environment and has no liquid in it when the manufacturer delivers it.

We generally use a minimal dilution as I think more concentrated Botox allows us to use fewer needle sticks.  Others dilute it more, but my concern is that higher dilutions may not last as long.

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A: Botox needs to be reconstituted

David Shafer, MD
10 months ago

Apeeling One, Botox come freeze-dried and needs to be reconstituted. It come in 100 unit and 50 unit vials. It needs to be mixed with preservative-free normal saline. The amount of saline used determines the concentration. I hope this is helpful. David Shafer, MD New York City

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A: Botox is mixed the first time it is opened

Ronald Shelton, MD
10 months ago
It is mixed every time it is first opened. The same bottle has enough units of Botox to treat two to three cosmetic units. This rarely is all done on the same patient, and more commonly provides doses for two or three patients.
Web reference: http://www.thenyac.com

A: Botox comes in a concentrated powder

Jordana S. Gilman, MD
10 months ago

Every vial of Botox gets diluted when it is used.  Doctors may use different amounts of saline to dilute the powder, resulting in Botox that is more or less concentrated.  Depending on the areas being treated, one vial may be enough for 3 patients or it may only be enough for one patient.

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