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

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?

Doctor Answers 9

Is Botox ok when it's not Refrigerated?

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.

Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Are you sure the temperature reading is in Celsius...

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...

Ken Landow, MD
Las Vegas Dermatologist
4.6 out of 5 stars 9 reviews

Botox storage

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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

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

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.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews


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.  

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Do not use this Botox from broken refrigeratpr

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. 

Dornechia George Carter, MD
Dallas Dermatologist

I would not use it.

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.

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

Contact Allergan directly

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.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Botox after refrigerator failure

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.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 39 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.