Is It OK to Take Codeine for Pain Relief Before a Botox Appointment?

I have a Botox appointment coming up and was wondering if it is OK to take codeine beforehand for pain relief. Also, does Botox interact with muscle relaxants - should these be avoided before or after Botox treatment?

Doctor Answers 16

Is it ok to take Codeine for pain relief before a Botox appointment?

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Taking codeine to minimize pain associated with Botox treatment will not be necessary. Pain is minimal, and can be even further minimized by using ice and numbing cream prior to injections. I would recommend speaking with your provider ahead of time. I hope this helps, and I wish you the best of luck.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Botox and narcotics

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It wouldn't be necessary to take a narcotic such as Codeine prior to your Botox injections. If you're having treatment by a well-trained and experienced provider, you should be fine!

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Pain for botox injections

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I agree with the suggestions of the other doctors, but also recommend ice just before the injections. Ice is a great local anesthetic and can also reduce the chances of bruising by constricting blood vessels. 

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
4.9 out of 5 stars 182 reviews

Codeine before Botox

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There usually should not be so much pain that narcotics are needed.  Our office uses topical numbing medicine.  We use small needles as well.  Best to talk to a couple of experienced injectors and see how they do their Botox.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Botox and pain relief

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There have been great comments already. I have five strategies that help to minimize pain with Botox or other neurotoxin injections:
1. Pretreat with a topical numbing medicine for 5-10 minutes.
2. Use vibration, either manually or, better, with one of the new devices on the market that minimize pain with injection. There is a gate theory of pain, the body can only sense a certain number of things from a certain area at time. Thus, vibration can mask or crowd out some of the pain sensation of an injection.
3. Use a cool pack for 5-10 seconds prior to treatment of an area.
4. Inject with small-bore needles. I usually use a 32-gauge needle.
5. An injector’s technique makes a difference. Quickly performed, 90-degree injections to minimize the amount of pain sensation fibers encountered can decrease pain.
I try to use all of the above to minimize discomfort during injections.
Pretreating with a narcotic is probably overkill. Especially if there is aspirin or ibuprofen in the pill, which can exacerbate bleeding and bruising.

David J. Myers, MD
Salt Lake City Dermatologic Surgeon

Pre Medicating Before Botox Isn't Necessary

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Typically it just takes a few seconds to administer a Botox injection and there shouldn’t be any pain following the initial injection either. Codeine is a narcotic pain reliever that is meant for moderate to severe pain, which Botox injections aren’t. I usually recommend that if a patient is apprehensive, they take some plain acetaminophen before hand. In addition, ibuprofen and aspirin before or after Botox is not recommended either. “Dr. D”

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 reviews

Not necessary to take codeine before Botox

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With injection of Botox, there may be some mild discomfort for just few seconds.  Codeine should not interact with the Botox, but is likely unnecessary given the small amount of pain with Botox injection. 

(This answer is not intended nor implied to be a substitute for medical advice. The information presented in this posting is for patients’ general education only.  Always seek the advice of your physician or other qualified healthcare provider for further evaluation of your individual case.)

Mireille Chae, MD
Seattle Dermatologist

Botox and codiene

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I think that it is a bit excessive to need codiene prior to Botox injections. Often I use topical anesthetics for patients.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Codeine ok but not necessary

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I have not had any patients that require narcotics for Botox injections.  We use a numbing cream and leave it on for 10 minutes prior to treatment to numb the skin pricks.  A very thin needle is used to deliver the Botox.  If it bothers them at all, patients would describe the injection as irritating or as discomfort but not as painful.  Ask your plastic surgeon before the treatment.

Elizabeth Kim, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 29 reviews

Codeine is OK, but do you really need it?

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Botox is a little tender and if you have someone else driving you to and from your appointment there is no problem with the codeine interfering with the botox. The question is do you really need it or should you just take a tylenol (as directed on the bottle) a 1/2 hour prior to your appointment.

Try not to take aspirin, advil, motrin, aleeve, etc, for 5-7 days prior to your treatment since they may lead to increased bleeding and bruising.  

Itzhak Nir, MD, FACS
West Palm Beach Plastic Surgeon
4.9 out of 5 stars 41 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.