Thank you for your question caroline morgan. Botox should be stored in a refrigerator before or after reconstitution. If it has either been left at room temperature for prolonged periods or in a defrosting refrigerator over a weekend the potency of the product may be compromised. Full effects may not been seen and patients may not enjoy their results for the full three to four months. I recommend using product that has not been left at room temperature or in a defrosting refrigerator for prolonged periods. In our office we transfer our Botox to another refrigerator when our main refrigerator is defrosting. Good luck!
Once Botox has been reconstituted, it needs to be refrigerated. It is a protein which will degrade if not kept properly refrigerated. There will likely be no complications other than lack of potency due to degradation. I would advise discarding any medication that has not been properly refrigerated as this drug will be injected into individuals who are expecting that you have followed proper drug handling.