Azzalure vs. Botox: which is better?

Question

on Fox today there's an announcement that Botox has a new competitor in Britain called 'Azzalure'....it sounds like it's Botox (botulinum). Do you expect it to be the same, better, or worse than Botox?

Rupert Critchley, MD, MRCGP · Answer

Hi there! To be quite honest there is little between it other than different manufacturers. Results are more dependant on the practitioner and their personal training / experience. Azzalure spreads out a little more in the muscle where as botox stays more localised which may lead to a little variation. Hope this helps!Best wishes,Dr Rupert

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Azzalure is known as Dyport in the US.  Both Botox and Dysport are very effective and work in the same fashion.  More imporant than which product is who is injecting.  I train other injectors on the safe and effective use of Botox (and other injectables) and I do find that for the core aesthetic physicians (e.g. plastic surgeons and dermatologists) have the best foundation to learn how to inject.  For non-core physicians or nurses, I spend a lot more time focusing my teachings on assessment and the underlying anatomy.  It is not something they get a lot of training in during their medical training.  Most of Botox complications that reported is usually due to technique and inadequate assessment.  For the best results and least complications, would strongly recommend that you stick with a board certified plastic surgeon or dermatologist who does a high volume of injectables as part of their practice.

Kenneth D. Steinsapir, MD · Answer

Dear Kit

	Don't get too excited. Azzalure is Dysport, a botulinum toxin A product just like BOTOX is a botulinum toxin A product. Galderma has licensed with product from Ipsen for distribution of this product for aesthetic indications into the UK, the European Union, and certain parts of Eastern Europe and the Middle East. Medicis, the company that markets Restylane and Perlane, owns the rights to distribute dysport in the United States under the trade name Reloxin. FDA approve for Reloxin is anticipated at any time now.

	Azzalure is not better or worse than BOTOX but it is different. One unit of Azzalure is not the same as one unit of BOTOX. It is more likely that 2 to 4 units of Azzalure will produce a similar muscle relaxing effect as 1 unit of BOTOX. However, Azzalure may diffuse differently than BOTOX. So there will be a big learning curve for doctors as they begin to use this new product. Competition is a good thing but not hold your breath that this new botulinum toxin A will spark a price war.

Renato Saltz, MD · Answer

I have no experience with Azzalure and have been very happy with Botox injected in my patients

Michael H. Gold, MD · Answer

This is a great question, and it gets into the naming of different drugs in different countries. In the U.S., we have Botox, Dysport and Xeomin. The same drugs in most parts of Europe are known as Botox (or Vistabel), Dysport or Azzulare, and Xeomin or BoCotture. So what you need to know is the same product may have different names in different countries. But the drugs are the same – so Dysport = Azzulare, no matter what the label says. Depending upon who is injecting the product and their experience, someone might like Botox more; someone else might prefer Dysport or Azzulare. The biggest difference is when you use these, you need to understand that when mixing them, we have to use different dilutions of saline to mix them – which should be of no concern to you – but should be to the clinician. More Dysport units are needed than Botox units for each indication – but this does not mean there is no difference. Twenty units of Botox equal about 60 units of Dysport; the units are not interchangeable, so this is the way it is. Depending upon the injector, you can get great results with both. Find a board-certified dermatologist or plastic surgeon, and learn more about this from them.

Naveen Somia, MBBS, PhD, FRACS · Answer

Botox was the First on the Market followed by Dysport and Now Xeomin.All 3 are Botulinum Toxins but with minor modifications to the structure but not the function.They are known by different trade names in different countries e.g. Azzalure and Vistabel

A. Peter Salas, MD · Answer

Azzalure is a brand name for a formulation of Botulinum Toxin Type A . The same material that is found in Botox.

	In the USA the brand name for Azzalure is Dysport. In other words the active ingredient in Azzalure is exactly the same as Dysport.

	Dysport recently received FDA approval for use in the USA. Dysport is available through a company by the name of Medicis. This is the same company that makes Restylane and Perlane.

	Even though the dose required to achieve a desired result is different that Botox, Dysport functions in essentially the same way.

	Undoubtedly some patients will respond better to Dysport while others will respond better to Botox.

	Each manufacturers will most likely claim to have the better product. However, only time will tell if one of the products is superior to the other.

	Good luck with your procedure.

Imogen Bexfield, BChD - Account Suspended · Answer

I have tried all the Botulin Toxin brands on the market and I personally prefer Azzalure as I feel it gives a stronger result, works quicker (sometimes within 3 days) and lasts longer. However, I do select the Botox brand for some clients who want a ‘baby botox’, softer approach or where they have increased upper eyelid tissue as it diffuses less and so there is less risk of eyelid dropping with these clients. Therefore, I think it’s important to adopt an individualised approach and select the best product to suit each client.

Anifat Balogun, MD - Account Suspended · Answer

Azzalure is a botulinum toxin type A that just recently received marketing approval in the UK. Azzalure is made by Ipsen, the same company that makes Dysport, which was finally approved for use in the USA by the FDA at the end of April. Dysport has been in use nearly worldwide for the past 20 years and has a good history of consistency and safety. Dysport will be marketed in the US by Medicis, the makers of Restylane and Perlane, while Azzalure will be marketed by Galderma.

	Azzalure and Dysport have the same indications as Botox. There is no discrete information currently available on how Azzalure compares to Botox in terms of cost, dosing and duration of muscle relaxation.

	Better than Botox? For now it is safe to say Azzalure is comparable to Botox.

	Look for Dysport, likely to be known in the US as Reloxin in the next 3 to 6 months.

	Good Luck, kit09.

Azzalure vs. Botox: which is better?

Answers (9)

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