200 Units of Botox?

I Posted a Previous Question About 200 Units of Hydrated?... Common theme that botox does not come in a 200 unit vial. and 10ml was 2much to recon. when the pack. insert says 10ml) My PCP gaveRX since he does not do the botox and said to take it to a derm.or CS.(hyperhydrossis). My ins. co. paid and sent it to me from Aetna Sepeciality Pharm. So, I'm confused about the "no 200 unit vial of botox avail.". especially when it was sent from an ins. co. pharm. Dr. is on vacaion of course. Want to avoid another very high copay, if botox would still be good.

Doctor Answers 5

Botox 100 and 200 units

Botox Cosmetic is available in 100 and 200 unit bottles in Canada.  The 200 unit bottle is very convenient for busy injectors.  Botox Therapeutic (for hyperhidrosis) is available in 100 unit bottles.  The typical dosage for the underarms is 100 units each side.

Toronto Dermatologist
5.0 out of 5 stars 22 reviews

200 Unit Vials of Botox?

Hi Angela.  Well, you learn something new every day.  We have never had a need for a 200 unit vial of Botox, but now understand that it does exist.

We typically treat Hyperhidrosis at 50 units per underarm so we would never have had a need for the larger vial.  We are wondering if you have you had this procedure before and how many units were injected?  Were 200 required?

We also find it a bit strange that your insurance company would send it directly to you given the storage and expiration requirements.   Given the amount of contributing physicians on this website, hopefully you will be able to find a good one near you that can help with the injections.  Hope this helps and good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

This is a non-issue.


Yes there is a 200 unit vial of BOTOX available in the US Market.  It is just not very commonly used by the doctors who post on Realself.  Although it is available for both medical and cosmetic preparations, it is just much more common for docs to order 50 and 100 Unit vials.  I would recommend that you get your 200 unit vial filled as two, 100 unit vials.  This will give the physician doing your axillary treatment more flexibility.  Why open a 200 unit vial that will need to be wasted if you only need a 100 unit treatment?  The doctor can store the other vial for you for when you need it.  This vial can be stored unreconstituted to a very long time.  However, one the vial reconstituted  it beings to rapidly decay in strength, although the rate of this is debated.  Keep the vial stored in the freezer and bring it with you for your appointment.  I would communicate with the dermatologists office ahead of time to make sure they can do this treatment for you at the time of your initial appointment.  So there is no misunderstanding, make sure you take notes of who you are speaking with at the office.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Two 100 Unit Bottles are 200 units of Botox

Botox is frequently used for treatment of hyperhidrosis (excessive sweating), especially in the underarm areas, where excessive sweating can easily ruin clothing as well as being a source of embarrassment. The usual dose is 100 units per underarm, for a total of 200 units.  This is generally dispensed as two 100 unit bottles, one used for each underarm.  Therefore, the prescription for 200 units of Botox could easily have been filled with 2 vials, each containing 100 units.  When your treating physician returns from vacation, you will likely be able to confirm this.

Sheldon V. Pollack, MD, FRCPC

Medical Director, Toronto Cosmetic Skin Surgery Centre, Inc.

Sheldon Pollack, MD
Toronto Dermatologic Surgeon
5.0 out of 5 stars 1 review



it sounds like the another route to take is to seek advice from the plastic surgeon who is injecting the area for your condition as this would limit the amount of leg work that you seem to be caught into. good luck

John Pak, MD, PhD
Chicago Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

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.