Should Botox be reconstituted with preserved or non-preserved 0.9% NaCl?

Question

I know with STS you can use the bacteriostatic 0.9% NaCl, but Botox (Allergan) states the non-preserved should be used for reconstitution. Thank you, Rosann

Martin Jugenburg, MD · Answer

It is recommended that botox be reconstituted with non-preserved saline, however there are many clinics that you preserved saline.

Stephen Weber MD, FACS · Answer

I have not found that it matters. As my colleagues have pointed out, preserved saline is more comfortable than non-preserved. The package insert reflects the conditions used for initial studies of Botox.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Jason Emer, MD · Answer

It is recommend to mix with unpreserved saline, but it hurts more so I use presevered as well -- it is less painful and has no change in the clinical result.  Best, Dr. Emer.

Asif Pirani, MD, FRCS(C) · Answer

Botox was approved for use when reconstituted with non-preserved saline.  Having said that, many people use preserved saline for patient comfort.

Joseph A. Eviatar, MD, FACS · Answer

I prefer to use preserved saline for reconstitution because it is slightly more comfortable for the patient but the FDA trials were done with unpreserved saline but there is no difference in duration of effect either way or onset of action.

Should Botox be reconstituted with preserved or non-preserved 0.9% NaCl?

Answers (10)