Doc, What Are All the Difference Between Chinese B-tex and USA Botox?

Question

doc, pls give me a detailed answer on doc, what are all the differance between chinese b-tex and USA botox.

Ron Shelton, MD · Answer

American physicians can only use FDA-approved Botox from Allergan.  All other countries who produce Botox may have different regulations and standards.

Martin Jugenburg, MD · Answer

Using a drug that is not locally approved means that it has not met the standards set by the local authorities. Given the very serious potential side-effects of the toxin (yes a toxin, a poison), you would be very wise to stay with a product that you know has gone through the scrutiny of the FDA. A different product may be just a poor knock-off, may be more or less potent, may have other components in there that can have negative adverse effects, or can simply be manufactured at a facility where quality controls are lacking and you happen to get a bad batch and it's goodbye for your. I personally am very suspicious of Chinese products because of the lack of quality control that takes place in that country. You don't have to think too far back to recall stories of food products from china that caused people to die. Baby formulas, pet food, the story of processed cardboard particles in hamburgers to add substance to the meat. All real incidences, not scare mongering.

Sincerely,

Martin Jugenburg, MD

Sincerely,

Martin Jugenburg, MD

Harold J. Kaplan, MD · Answer

The obvious answer for US based practitioners is that B-Tex is not FDA approved.  The FDA requires that pharmaceutical companies rigorously test their products for safety and efficacy and B-Tex is not FDA approved here in the US.

	Because the products is not FDA approved, we would have questions about the exact type of toxin used, the strength, side effects and duration (effectiveness).

	On top of the regulatory and efficacy issues, there is also the issue of quality control - safety.  The US is being inundated with counterfeit pharmaceutical products from China and the only way to ensure that patients get the proper medications is by buying directly from US based manufacturers that maintain strict quality controls.

	Although the other product is probably cheaper, we would stick the Botox for now.

Kenneth D. Steinsapir, MD · Answer

It is no joke that botulinum toxin A is a deadly poison. It is rigorous quality assurance practices that makes these products safe for clinical use. Allergan carefully tests and standardizes BOTOX. This means that a clinician picking up vial of BOTOX can draw up a certain number of units of BOTOX and know that this will be precisely what is in the syringe each and every time. Think you can say that about that vial of botulinum toxin A that someone has illegally smuggled into the United States? No you can't.

Jeffrey Zwiren, MD · Answer

I would not trust any Botox like product other than the real thing.  There have been cases where patients have ended up with Botulism from non regulated sources.  Too risky to even try.

Darryl J. Blinski, MD · Answer

Easy! Botox is FDA approved to be used in the practice of medicine in the USA while Chinese B-tex is NOT!

Michael Bowman, MD · Answer

Medications which are FDA approved are known to have met certain standards of quality, just like a board certified physician.  You may be able to get a drug or procedure at a discount, by pursuing such medications or practitioners, but you can't be sure of what you are going to get. 

	The standards of purity and regulation that are inherent in FDA approved medications do mean they will cost more than a chinese b-tex or other medications, but I feel strongly that any drop in price is not worth the risk. I would also be cautious about a practitioner offering such a product.  Such a practitioner may be focusing too much on quantity and discounts and not enough on quality (quality of product, quality of training/education, etc).

	 

	Best wishes!

Louis W. Apostolakis, MD · Answer

In the United States there are three botulinum toxin type-a formulations approved for cosmetic use.  The most known is Botox which has been available for more than 20 years.  Dysport has been available in the US for about 1.5 years now.  Xiomin was approved several months ago but is just now shipping to physicians in test markets.

	While it is true that Botox has the longest track record, I don't think Dr. Smith's comment about it having better quality can be supported.  Dr. Kraft's inference that only Botox brand is approved for cosmetic use in the US is inaccurate.  Dysport and Xiomin are both manufactured by companies which are held to the same FDA standards and all three have fine reputations.  The products have all gone through the same FDA approval process.   They have also been used for many years in Europe prior to their introduction here. In my personal opinion, Dysport is currently the best botulinum product available for cosmetic use in the US, though only slightly better than Botox.

	If you are receiving Chinese B-tex in the United States, you and your provider are breaking the law.  The product would be coming to the United States via illicit channels and would be of unknown content and quality.  Beyond that, I can not comment on this product.

Robert L. Kraft, MD, FACS · Answer

Please do not use Botox that is not manufactured by Allergan Corporation for cosmetic use.  Unless another company's product has met the standards of the US Food and Drug Administration, there may not be proper oversight of its manufacturing and components.   Botox is a toxin and an improper formulation could be dangerous and even deadly. Certainly not worth the risk and lack of accountability.

Kenneth Beer, MD · Answer

The difference is that the Chinese Botox is not approved by US FDA and is likely to be counterfeit whereas Botox , Dysport or Xeomin purchased from a reputable dermatologist or plastic surgeon is approved by US FDA and should be directly delivered from the company.
	In the best scenario, counterfeit prouct doesnt work and leaves you hungry for real product in a short amount of time. In the worst case scenario, it is contaminated and results in problems.

	Dont look for discounts, you wont love them long term.

Doc, What Are All the Difference Between Chinese B-tex and USA Botox?

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