I Had a Vial of Unopened Unreconstituted BOTOX in the Fridge and the Fridge Broke Overnight. Can It Still Be Used?

Question

The temperature in the fridge got up to 37 degrees celsius. Also how long does a bottle of reconstituted Botox last if it is refrigerated? Does it effect it's duration of action?

Harold J. Kaplan, MD · Answer

Hi Dr. Giard.  If the temperature went up to 37 C, then it's likely the product is no good.  I think some of the other physicians that were commenting might have been thinking in terms of Farenheit temperatures.  This is about 98 degrees farenheit.

As many of the other panelists have noted, if you have a relationship with your Allergan sales rep, it's likely they would offer to replace the vial  They have the ability to do this if the product has been compromised in some way.  Good luck.

Ron Shelton, MD · Answer

if the Botox was subjected to 37 degrees celsius, its efficacy might have been affected. Contact the science division of Allergan and ask the manufacturer, but I would strongly recommend not to use it. Physicians should only order Botox from the manufacturer, Allergan, and no other source. Reconstituted Botox should be kept in the refrigerator and most doctors agree, that off-label, its effectiveness is not affected if it is used within two weeks, but many say even more. Experienced physicians use Botox so often that it is rare to find one vial in the refrigerator more than one to two working days.

Kenneth D. Steinsapir, MD · Answer

Aside from how you got this vial, Allergan has advised physicians that this product is sensitive to environmental conditions. It is likely that the product has been degraded by these high temperatures. No one will vouch for the safetly of this product. You have written it for our advice: DO NOT USE THIS PRODUCT.

Ken Landow, MD · Answer

a refrig with a closed door that lost power just overnight would not get to 37 Celsius which is almost 100 Fahrenheit...that's much too warm/hot...it like room temperature in the desert and wouldn't be expected for several days/weeks in winter time...and that's if the refrig were outdoors and not in a home kept at 72 - 76 Fahrenheit...and yes the botox wouldn't be much good at that temperature...if on the other hand you mean the temp was 37 Fahrenheit, then the botox is okay if the power was just out overnight...

Dornechia George Carter, MD · Answer

Botox, as well as many other medical products, require pretty strict storage requirements with monitoring, and reconstituted Botox is not indicated to last for very long.  Aside from concerns about non-medical professionals having a home supply of a neurotoxin, the storage in a home refrigerator is questionable.  Frequent opening of the door, as well as the addition and removal of room-temperature items can lead to temperature fluctuations beyond what is indicated (the same reason it is recommended that you do not put eggs on the door of a fridge). 

	Additionally, I agree with the comments previously posted.  If you obtained this Botox outside of a medical professional's office (I can't imagine one that would send you home with it), only goodness knows what its' true constitution is.  Many products are sold on the grey market and may be of questionable efficacy and safety, and administration by an untrained individual may lead to unintended adverse effects.

Robert L. Kraft, MD, FACS · Answer

I have two comments on your post.  First, I am assuming that you are a non-physician so why do you have Botox in your refrigerator?  Medical professionals store Botox and other pharmaceuticals requiring refrigeration in separate medical refrigerators.   If you are not a doctor, you should not have this product, which is a toxin in your possession.  Secondly, as Allergan does not sell Botox to non-medical professionals, it is altogether possible that what you have may be grey market goods, mislabeled product  or, worse yet, what is called scientific grade Botox which is not meant for cosmetic purposes and can cause morbidity or mortality.  If this is your circumstance, I encourage you to hand whatever you have to the authorities as it could be dangerous.

Francis R. Palmer, III, MD (retired) · Answer

IMHO it's best for you to contact and ask your local Allergan rep.  They might just exchange the Botox vial for a new one.

David Alessi, MD - Account Suspended · Answer

If it only went up to 37 degrees for a 12 hours period, it is unlikely to have deteriorated significantly.  However, contact Allergan for the official word.

F. Victor Rueckl, MD (in memoriam) · Answer

I would think this is ok, but for your best answer, consult Allergan. They have done many, many tests on temperatures, reconstitution, refrigeration vs freezing, etc. They will know if there will be any problems in using the vial and if there might be any effects on its durability.

I Had a Vial of Unopened Unreconstituted BOTOX in the Fridge and the Fridge Broke Overnight. Can It Still Be Used?

Answers (9)

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