What if Botox was mixed with 5% dextrose solution instead of saline?

Doctor Answers 6

Reconstitution of Botox

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Thank you for your question didtjwns. Botox comes as a dry powder in a vial and is reconstituted with normal saline per the manufacturer's guidelines. Many offices use preserved saline, which has the advantages of lasting longer and being more comfortable when injected. The composition of 5% dextrose is different from that of normal saline. Saline can also be prepared as D5S, which is normal saline plus 5% dextrose. There are no studies comparing reconstitution of Botox with D5S with reconstitution in normal saline. So we do not know the answer to this question. Any time I do not know the answer to a question like this I always go by the manufacturer's guidelines. This reduces errors and complications. Good luck!

Botox mixed with Dextrose solution

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It will not have any negative effects other than the Botox might not work as well. It probably would be absolutely fine but this is not what is typically used. Most physicians used preserved normal saline. It is more comfortable than normal saline.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Don't panic

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Aside from discomfort during injection, you should be fine. Swelling can occur, but should resolve within days and it is likely that the Botox will work the same. If swelling occurs, the toxin can spread to undesirable areas. 
In short, if you have had no significant swelling or pain, all will likely be fine. It is unlikely the dextrose will break it down and it will likely last just as long as if it were mixed with normal saline.

Robert S. Bader, MD, FAAD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Botox mixed with dextrose - a problem?

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Large ph changes can cause difference in protein dissociation but have not shown to change activity of the molecule; however, I'm not aware of any studies with d5.  If the botox used was accidentally diluted with D5 instead of saline, it is unlikely to change the effect.  Botox proteins should not be effected by this as the ph is the same.  

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Mixing of Botox

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Mixing Botox with anything but normal saline is totally contraindicated. this solution would not only probably destroy the molecule but would be very painful to inject

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 7 reviews


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The manufacture recommends reconstituting with normal saline.  I cannot think of any reason why one would reconstitute the botox with Dextrose in Saline.  If one were to use dextrose in water, I would imagine it would damage the botox molecule.  

Elliot Duboys, MD, FACS
Long Island Plastic Surgeon

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.