Will combining Upneeq and Botox lead to any adverse side effects or affect performance and longevity?

Upneeq will definitely not have any effect on the longevity or effectiveness of Botox. It has been proven to significantly improve lid ptosis and typically will last around 12 hours.

Upneeq and Botox can be used together around the eye with minimal risks when treated by a professional. There is no direct interaction as they work on different receptors on separate pathways (one parasympathetic, one sympathetic) so they should not cause any change in their performance or longevity. However, both carry a risk of worsening dry eye symptoms and incomplete eye closure. Botox below the eye will decrease the orbicularis muscle strength and decrease wrinkles and bunching of the lower lid and Upneeq will activate the upper lid Muller's muscle raising the lid. In combination you end up with a more open eye. I recommend to always have an evaluation by your eye doctor or Oculoplastic surgeon before using Upneeq.