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Is Continual Use of Iopidine for Drooping Eyelids from Botox Safe?

I got botox for a year and loved the results! I never had any drooping around my eyelids. Then, suddenly my one eye started to droop EVERY time I got botox. Sometimes now my other eye gets somewhat droopy. I use iopidine that takes away the droop so that I can enjoy no forehead wrinkles and fewer headaches. Is it safe for me to get continuous botox injections and just use iopidine drops for my droopy eye(s)?

Doctor Answers (2)

Consequences of Prolonged use of Lopidine to counteract repeated misplaced Botox


Misplacement or migration of Botox into the upper lids will weaken the lifting muscle of the lids (levator palpebrae superioris muscle) resulting in a tired, sleepy look (Upper lid ptosis). The effect can be somewhat reversed with the use of several classes of eye drops including Iopidine™ (apraclonidine 0.5 %) eye drops, an anti-glaucoma (high eye ball pressure) medication. Beside lowering pressure in the eye, the active ingredient Apraclonidine causes Müller muscles in the upper lids to contract and lift the upper eyelid 1-3 mm.The usual dosage is 1-2 drops every 8 hours or so in the affected eye until the Botox effect wears off. It should be used with caution in patients taking Beta-blocker eye drops (eg, timolol), or certain pills for high blood pressure (such as beta-blockers (eg, propranolol), digoxin) and those taking MAO inhibitors (eg, phenelzine) for depression.

More importantly than worrying about using a prescription medication, I think you need to start questioning WHY you keep suffering repeated episodes of misplaced or Migrating Botox paralyzing your upper lid muscles. Most of us who inject Botox routinely and do it well have few to no such cases but have seen them coming through our offices commonly when Botox is administered by inexperienced injectors often in a salon or spa setting.

Maybe it is time to consider getting your Botox elsewhere.

To read everything you need to know about BOTOX and Bad Botox, follow the informative link below.

Dr. P. Aldea

Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

Iopodine for droopy eyelids


I'm not sure if your question of safety of long term iopidine has been addressed. Check with your physician if treatment for your headaches can involve injecting the forehead differently, maybe eliminating lower forehead areas, especially the zones that are located vertically above the eyes. Usually injections in the glabella, the region between the eyebrows and immediately above, does not cause drooping but helps lift the eyelids!

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.