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

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.  

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!

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.