Botox Q&A

64%

WORTH IT RATING

854 Reviews

Ask a Question

View Before and Afters

Average Botox Cost: $425

Learn about Botox

3,016 people and 923 doctors are talking about Botox

Get Free Email Updates

Adverse Effects of Expired Botox

asked 11 months ago by mykr in Brookfield, WI
Latest answer by Ronald Shelton, MD
Question viewed 750 times
Tags: expiration date, risk, side effects

I believe I received botox that had expired 5 months ago. I am having pain & spasms above my left eye. What are the risks of using expired diluted botox?

15 answers to Adverse Effects of Expired Botox

Risks of Expired Botox?

Hi Mykr. The risk of expired Botox would generally not include eye spasms. It's more likely that if it was reconstituted (mixed) and then was left for 5 months that the chance of infection would be greater. Even more likely than this scenario is that the product simply would not work as well. Either way, the symptoms you are experiencing are likely not related to the Botox and you should visit your primary care physician. Good luck. more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Side effects from expired Botox

The most problematic effect of using Botox diluted 5 months ago is that there may have been bacteria in the liquid. But the most likely is that the Botox may have lost some of its potency and simply will not work as well. Usually Botox is diluted with bacteriostatic saline and is stored in the refrigerator, so if it was reconstituted properly, even the chances of infection are very low. All that said, no, Botox should not be used 5 months after expiration and/or dilution. ... more

Emily Altman, MD
Short Hills Dermatologic Surgeon

Expired Botox

The expiration on Botox is very long. For instance, Botox in my office right now does not expire until 2012. However, Botox that has already been reconstituted or diluted should be used within 24 hours. If you had Botox that was sitting around diluted for 5 months then this is a problem since you are obviously being injected by someone who does not know what they are doing and does not do many Botox injections if they have Botox sitting around for that long. However,... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

The Risks of Using Expired Botox

If the Botox was handled and reconstituted properly, the only risk of using Botox past the expiration date on the bottle is that it may "theoretically" loose some of its potency. There should be no further risk of anything that would explain the symptoms you are having so you should not be concerned that it was due to expired Botox. Your experience underscores the importance of selecting a physician's office that treats many patients with Botox in the course of a normal day.... more

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

By expired, I assume you mean that the date on the vial was past the printed date.

It is very interesting about the pharmaceutical industry. Those expiration dates probable have much more to do with marketing than product safety. The Navy did a study on drugs because they have to store drugs on big ships and it is very inconvenient to constantly restock drugs. What they learned is that most drugs are still good 10 years after the date of expiration. There are some important exceptions like nitroglycerin for the heart. I think I would want to... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Unlikely to have a complication from old Botox

As long as the vial was not contaminated, there should be very little risk to using Botox that expired 5 months ago. The most likely side effect from using outdated Botox is that the Botox would be less effective due to degredation of the molecule. I would recommend discussing this with your injector. It would concern me that outdated Botox would ever be used on a patient. There is really no reason this should ever happen. Busy cosmetic practices should be using so much Botox that they never... more

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon

www.campbellplastics.com

Expired botox

You should contact the manufacturer, Allergan, as their science division might have the best answer for you. Chances are that as long as the product had not been mixed five months ago, and was stored sterilly in the freezer until it was mixed and then given to you, that there probably is no risk. After a long while, possibly years, a product might lose its sterility, but possibly there is a gradual loss of potency. Whether there is degradation of product that could cause a problem needs to... more

Ronald Shelton, MD
Manhattan Dermatologist

Expired Botox

There should be no adverse consequences or risk from expired Botox in terms of pain and spasms unless there has been bacteria formation in the diluted fluid. Botox should be refrigerated upon reconstitution. A busy practice with a Botox population would not have expired, open vials. The problem with an expired medication or injectible is loss of potency. I would be reluctant to return to a physician who used an expired substance which may have weakened to the point of limited, if any,... more

Robert L. Kraft, MD
New York Plastic Surgeon

Expired, diluted Botox effects.

IMHO, diluted, which I think you mean reconstituted Botox, that's been left in that form for 5 months would be very weak and have little effect, not the spasms and what you are describing.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Expired Botox

Expired Botox if not reconstituted is probably ok. I doubt that it would cause the problems that you are having. If it was diluted for the past few months, it would probably have very little effect.

Steven Wallach, MD
Manhattan Plastic Surgeon

Botox safety

Most drugs are safe for considerable time after expiration and Botox is no exception. Pain is not a likely effect, so you should consult a doctor. Expiration may reduce potency but should not cause harm.

Hugh McLean, MD
Mississauga Plastic Surgeon

Expired Botox

Two issues: sterility and expiration date. If (as you say it was) the vial of Botox was expired, at the worst it woudn't have work. Now, if the vial was contaminated (meaning the content was no longer sterile) then you can get an infection. The main question is: do you know if the vial was reconstituted JUST prior to your injection or was reconstituted months prior to your injections. In the latter case, the Botox wouldn't have worked at all.

Henri P. Gaboriau, MD
Seattle Facial Plastic Surgeon

Adverse Effects of Expired Botoxt

Very very unlikely you would have any complication using expired unreconstituted or reconstituted BOTOX. Except it might not give you the effect desired for $'s used.

Darryl J. Blinski, MD
Miami Plastic Surgeon

BOTOX® is exceptionally stable

BOTOX® is exceptionally stable, both before and after reconstitution, so the risk to you from using BOTOX® past it's expiry date is essentially zero. In fact, BOTOX® is so stable that it is somewhat difficult to destroy BOTOX® [for example, when getting rid of left over supplies at the end of a clinical trial]. If your symptoms persist, you should see your doctor to determine what is causing the problem.

Kevin C. Smith, MD
Niagara Falls Dermatologic Surgeon

Expired Botox

Most reputable cosmetic practice get new shipments of Botox every month so nothing sits around, especially stuff that has been reconstituted. If the Botox you received is still sterile, it is just weaker. If it is not sterile then you may have a soft tissue infection.