POSTED UNDER Botox REVIEWS
Botox and Antibiotics - a Bad Combination - Australia
ORIGINAL POST
I was taking a tetracycline antibiotic...
$200
I was taking a tetracycline antibiotic (doxycycline) when I had 15 units (total) of Botox injected. I had been taking the 25-day course of doxycycline for 18 days before the Botox and 7 days after the Botox. I had the Botox injections on 10 July.
The Botox was put in my frown lines, above my eyebrows, in crows feet area, in bunny lines and one under the eyelashes of my left eye. A total of 9 injections and a total of 15 units. Not much. I have had Botox twice before - Oct 08 and April 09.
It would appear that the antibiotic increased both the physical impact and the side effects of the Botox. The other two times I have used Botox I had similar amounts administered (around 15 units) in the same places and I had stable results in around 5-7 days. The muscles were relaxed but not frozen.
It has now been 14 days since the last injections and the Botox is still paralysing my muscles. My forehead is cement, both sides of my face have dropped, my brow is lowered and upper eyelids swollen. I have puffy bags / pouches underneath my eyes because the complete freezing of the eye muscle in both the crows feet and bunny lines areas means that the area under my eyes has nowhere else to move except inwards, particularly when I make a facial expression. I have the 'chipmunk' look when I smile because the sides of my face can't move anymore. (I have no reason to smile anyway.)
I also had severe side effects (see other posts), which has never happened before. Previously I had mild side effects for a few days - headache, a bit of anxiety etc. This time it has been very severe and very debilitating.
I have reported the adverse outcome to the FDA in the US and to Allergan in Australia but was informed that interaction with antibiotics such as tetracyclines and aminoglycoside antibiotics is "THEORETICAL" because no clinical testing has been done. Therefore, no data is available and nobody can tell me what is going to happen. It is clear that the Botox effect has been dramatically increased by the antibiotics, but I am very worried that the duration of the effect will also last longer. I am hopeful this is not the case. Has anyone else had a similar experience with Botox and tetracycline antibiotics?
UPDATED FROM tried but failed
Has anyone with a bad Botox result used anything...
Has anyone with a bad Botox result used anything like the Tua Viso to try to stimulate the deadened muscles once they started to re-engage? In my previous Botox experiences (which might be different this time because of the antibiotics) the muscles started to move again in around six weeks. The movement was weak but it was definitely there.
Would using an electric muscle stimulator assist the newly re-engaged muscles to strengthen and therefore correct the bad result more quickly? I am very wary of doing anything to make it worse so advice would be appreciated. My Botoxed muscles are still completely dead so I have a few weeks before I could even try this. Does anyone have any thoughts or experience with this?
Replies (2)
August 25, 2009
Hi! Sorry for what you are going through. Know that you are helping others by going public with this. Is it possible you were given inferior Botox? I could be wrong, but I am of the impression that Botox eventually dissipates. (it is not a permanent fix). As I understand it the Botox that resulted in this was just done in 7/09. I heard it lasts for at least 6 months. I would see a neurologist for a second opinion to make sure nothing else is wrong and wait it out. I am just a person, no expertise, but have had my share of problems in life. You will be in my thoughts. Keep us posted on outcome.
August 26, 2009
Hi Researcher - thanks for your post. The Botox was definitely genuine (manufactured by Allergan). I am in Australia so there is not a huge market here for inferior or fake Botox. It was definitely the combination of the antibiotics and the Botox that made the outcome so bad. I am happy to report that the side effects I experienced have abated and the physical effects have finally settled down. I realise it is temporary but my muscles (especially around my eyes) are so paralysed that I know it is going to be many months before I look 'normal' again. This Friday it will be seven weeks since the Botox. I can say that I definitely have more movement in my face and there has been some improvement but I have a long, long way to go. Cheers.
UPDATED FROM tried but failed
I have asked the doctors about the Tua Viso to...
I have asked the doctors about the Tua Viso to speed up the recovery from my bad botox result. Hopefully I will get an answer!
Replies (6)
September 18, 2009
Hi I was wondering if you are aware that the main purpose of Botox is to actually paralyze the muscles? That is how it works to control the appearance of wrinkles. And is there a possibility that you may have rubbed the injected areas thereby pushing the injected Botox into other areas? Even sleeping on your face the night of the injections can displace the Botox. (This would cause the drooping you are describing). I know that when Botox is injected it is placed in a very specific area - the area where the nerve innervates a specific muscle. Did the same person do your Botox all three times you had it done? Also there is a possibility that the Botox you were given could have been mixed wrong and or stored wrong.
I don't see how the Tetracycline would potentiate the effects of the Botox. There are antibiotics that work as aminoglycosdies (they interfere with the neuromuscular junctions as does the Botox). However Tetracycline is not in that class of antibiotics.
If I had to guess I would say that because Botox is essentially a bacteria and the job of Tetracycline is to kill off the bacteria, it would actually lessen the long term effects of the Botox. I found your post because I was wondering if the Tetracycline I was given for a slight acne problem would in any way shorten the results of the Botox...
September 19, 2009
I am aware of the purpose of Botox. I am also aware of how the product works. Botox blocks the transmission of acetylcholine from the nerves to the muscle. Acetylcholine is a neurotransmitter which send a message to the muscle telling it to contract. With the flow of acetylcholine is blocked or significantly reduced, the muscle can no longer retract and it relaxes. As a result, the wrinkled areas smooth out and soften.
I did not rub my face. I did not sleep on my face. The interaction between the Doxycycline antibiotic I was taking before, during and after the Botox potentiated the Botox effect causing both an unpleasant aesthetic appearance as well as side effects.
The same doctor administered the botox all three times in similar amounts in similar places. The amounts were minimal (around 15-20 units). On the third time, the Botox interacted with the Doxycycline and massively potentiated the Botox effect causing CHEEK PTOSIS from overweakening of the orbicularis oculi such that it is no longer strong enough to hold up my facial/cheek fat. The lower, outer part of the eye muscle works as an adjunct to the cheek levator muscle in this respect. My eye muscle was not 'relaxed', it was completely paralysed.
The product information sheet for Botox warns that caution should be used when administering Botox to patients who are taking antibiotics of VARIOUS CLASSES, not just aminoglycocides.
Due to the possibility that the effect of Botox may be potentiated, the Australian product information sheet reads that "caution should be exercised when Botox is used with aminoglycosides, spectinomycin, polymixins, TETRACYCLINES, lincomycin or any other drug which interferes with neuromuscular transmission." The Allergan information is similar.
Aminoglycocides are not the only class of antibiotic that interfere with neuromuscular transmission. Tetracycline antibiotics have neural blocking properties too, just not in the same way as aminoglycocides. DO SOME MORE RESEARCH.
Also, you might want to use the drug interaction checker at www.medscape.net Registration is free. This is the result for Doxycycline (a tetracycline) and Botox:
DOXYCYCLINE
BOTOX COSMETIC IM
Interactions
SEVERE INTERACTION
Doxycycline Hyclate Oral and Botox Cosmetic IM may interact based on the potential interaction between MISCELLANEOUS ANTIBIOTICS and NEUROMUSCULAR BLOCKING AGENTS.
MONOGRAPH TITLE: Misc Antibiotics/Neuromuscular Blocking Agents
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Aminoglycosides, bacitracin, clindamycin, lincomycin, polymyxins, and tetracyclines may enhance the pharmacologic effects of neuromuscular blocking agents.
CLINICAL EFFECTS: May see an increase in the pharmacologic effects of neuromuscular blocking agents, including prolonged respiratory depression and apnea.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: If it is necessary to administer these drugs concurrently, do so with extreme caution. Monitor neuromuscular function and adjust the dose of the neuromuscular blocking agent accordingly.
DISCUSSION: Concomitant administration of aminoglycosides, bacitracin, clindamycin, lincomycin, polymixins, and tetracyclines with neuromuscular blocking agents has been shown to produce synergism of the effects on skeletal muscles. Concurrent administration of these drugs has been associated with prolonged respiratory depression, respiratory paralysis, and fatal apnea. The interaction usually occurs when the antibiotic is given prior to or concurrently with the neuromuscular blocking drug, but it may also occur when given after administration. Any antibiotic dosage or route of administration may produce respiratory depression.
CLEARLY I HAVE NOT DIED!! However, I did have awful Botox side effects (which had never happened before) AND an unnattractive physical effect.
You may not see how tetracyclines can interact with Botox, but the medical profession certainly can. IF YOUR BOTOX IS STILL IN THE 7-10 DAYS WHERE IT IS ACTIVELY WORKING, I WOULD STRONGLY SUGGEST THAT YOU STOP TAKING THE ANTIBIOTIC IMMEDIATELY AND SEEK MEDICAL ADVICE.
September 21, 2009
Hi, a rep from Real Self sent me a link to your info. I am very scared! I received 30u cosmetic botox in my forehead and crows feet on 8/28. I had been taking azithromycin and Mepron daily for more than 2 months for Lyme disease. I informed the cosmetic surgeon of my Lyme history and my use of antibiotics and he said it was not contraindicated with botox. I too had a severe reaction that I attribute to the antibiotic interaction. I had flu symptoms, headaches,loss of appetite for 2 weeks and lost 10 lbs. I am also having EXTREME ANXIETY that I can't even find words to describe. I can't sleep. When I do sleep, I wake up within a couple of hours with pounding heart, sweats, and extreme anxiety. I have been to the emergency room twice and feel like I will not be able to make it through this. I am now on zoloft and xanax to try to control the anxiety but am still having alot of anxiety. I have reported this to Allergan, but they did not seem to take my report seriously and stated that my antibiotics would not have caused this interaction. I did stop taking the antibiotics a few days after the botox because I couldn't eat. But, azithromycin stays in your body for days after you stop taking it.
My eyes feel dry and full of gravel. I also feel like my face has dropped - chipmunk appearance. I initially felt like there was a tight band around my forehead but that has loosened a bit.
I've really got myself in trouble because now that I am no longer taking antibiotics, I am afraid my Lyme disease is going to get out of control again.
How long did your reaction/anxiety symptoms last. Are you starting to regain muscle control? It has only been 3 weeks and I can't believe this could go on for 6 months. Please reply as I really need to know there will be an end.
I hope you are over this ordeal! Thank you.
September 21, 2009
Please do not panic. I know exactly how you feel. I had to take Valium (like Xanax) for about a month just to be able to sleep and function during the day. Be careful with Zoloft - isn't one of the side effects increased anxiety especially when you first start taking it? Maybe you should check that out? HANG IN THERE. I can assure you that it will get better. I reported my reaction to Allergan Australia and they were not very interested. I also reported my reaction to the FDA and the TGA (Australian FDA). Not much interest there either. There IS information about the interaction between antibiotics and botox - including information from Allergan itself. The Australian government produces a botox information sheet which contains a caution against using botox with certain antibiotics (including aminoglycocides, tetracyclines and others). The information above from www.medscape.net did not come from nowhere! Do not believe your doctor that no interaction exists. Your doctor is covering up his own mistake. I am sending you a private email so we can talk about it properly. Cheers
September 21, 2009
I have also posted a couple of replies to your review. Sorry they are so long but I can be a bit wordy! Hold on - it WILL get better. I am thinking of you because I know exactly how you feel. This website is an absolute godsend and I hope it helps you as much as it helps me. Stay in touch. Cheers.
December 18, 2010
Hi Tried but failed, I was wondering how your eye area is now? Has it recovered? I had one unit of Botox injected under both my eyes six months ago and the eye area is still collapsed :(( It's not as bad as it was but it is not back to normal, I am just so frustrated and horrified that it is not going to return to the way it was before, completely tight and line free. I would be much obliged if you could give me an update on your progress if at all possible...
Replies (7)
But never the less, the toxin routinely takes 10-20 days to fully be absorbed so your adverse event symptoms would be evolving (worsening) over that time period. The more toxin that gets into the bloodstream the more severe the reaction so although the injecting doctor doesn't mean to introduce poison to you system wide, it happens. And it happens often on the 3rd or 4th injection. There is a even a case study of a woman who had 16 injections with no issue and the 17th one hospitalized her and left her permanently disabled. There is a summation effect that is not clearly understood but very obvious in research studies on animals. There are also people who have died with 15 units so no amount is safe. Not in theory, not in practice.