Botox (Botulinum Toxin Type A)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Botox Used For?
Botox contains botulinum toxin type A, a muscle relaxant obtained from the bacterium Clostridium botulinum. It works by temporarily relaxing overactive or spastic muscles and can also block signals to sweat glands and pain-related chemicals in the brain.
Primary Uses
Botox treats medical conditions with overactive muscles including: excessive eyelid blinking (blepharospasm), facial muscle spasms, lazy eye or squint (strabismus), voice problems from throat muscle spasms (spasmodic dysphonia), neck muscle problems (cervical dystonia), muscle spasticity in children with cerebral palsy and adults with focal spasticity. It also treats overactive bladder with urine leakage, chronic migraine headaches, excessive armpit sweating, and cosmetic concerns like frown lines, crow’s feet, forehead lines, and neck bands.
How It Works
Botox temporarily relaxes overactive or spastic muscles. It can block signals to sweat glands to reduce excessive sweating, block chemicals in the brain associated with chronic migraine pain, and when injected into the bladder wall, works on bladder muscle to prevent urine leakage.
Good to know: Botox has been approved by the Department of Health for all the listed medical and cosmetic uses.
How to Take Botox
Botox injection should only be administered by a doctor familiar with the required technique. It must be dissolved in sterile saline solution immediately before use and should not be used in higher doses or more frequently than recommended.
Dosage Instructions
Dosages vary by condition: Overactive bladder: 100 U total dose via multiple bladder wall injections. Neurogenic bladder: 200 U total dose. Blepharospasm: 1.25-2.5 U per muscle. Strabismus: 0.05-0.15 mL per eye muscle, maximum 25 U per muscle. Pediatric spasticity: up to 8 U/kg, maximum 300 U per session. Adult spasticity: maximum 400 U per session. Cervical dystonia: maximum 360 U per 2-month period. Chronic migraine: 155-195 U across 7 head/neck muscle areas every 12 weeks. Excessive sweating: 50 U per armpit every 4 months. Frown lines: 20 U in 5 injection sites. Crow’s feet: 6-18 U per side. Forehead lines: 8-24 U in 4 sites. Neck bands: 26-36 U depending on severity.
Treatment Schedule
You may receive follow-up injections when effects begin to wear off, depending on your condition. Treatment intervals vary: bladder conditions every 3 months minimum, most muscle conditions every 3-4 months, chronic migraine every 12 weeks, excessive sweating every 4 months minimum, cosmetic treatments when effects fade (typically 3-6 months).
Important: For children, the maximum cumulative dose in a 3-month period should not exceed 8 Units/kg body weight or 300 Units, whichever is lower.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Local muscle weakness at injection site
- Temporary effects related to specific treatment area
Seek immediate medical attention if you experience:
- Loss of strength/muscle weakness
- Drooping eyelid
- Double or blurred vision
- Trouble speaking
- Aspiration pneumonia
- Trouble swallowing or breathing
- Changes to heart beats
- Chest pain
- Skin rash
- Allergic reaction (shortness of breath, wheezing, swelling of face/lips/tongue, rash, itching, hives)
- In children: pneumonia, seizures
Important Warnings
There are important safety considerations before using Botox. Tell your doctor about all medical conditions and medications you’re taking.
Who Should Not Take Botox
Do not use Botox if you: are allergic to botulinum toxin type A or any ingredients; have an infection in muscles where it would be injected; have muscle disorders like myasthenia gravis or Eaton Lambert Syndrome; are being treated for urine leakage and have sudden urinary tract infection, sudden inability to empty bladder (without regular catheter use), or are unwilling/unable to use a catheter if required; if the container is damaged or product looks abnormal.
Medical Conditions to Discuss
Tell your doctor if you have: muscle disorders including motor neuron disease; scheduled surgery requiring general anesthesia; take blood thinners or aspirin-like products; inflammation or severe weakness in injection site muscles; breathing problems like asthma or emphysema; swallowing, bleeding, or heart problems; had facial or eye surgery; drooping eyelids or facial changes; angle closure glaucoma; seizures; chronic urinary tract infections; urinary obstruction; diabetes (for bladder treatment). For children with cerebral palsy: neurological problems, swallowing difficulties, lung disease, or aspiration pneumonia history.
Pregnancy and Breastfeeding
Use of Botox during pregnancy or breastfeeding is not recommended. Tell your doctor if you become pregnant while being treated or if you are breastfeeding or plan to breastfeed.
Serious Warning: Tell your doctor if you have problems swallowing, speaking, or breathing. These problems can happen hours to weeks after injection, usually because muscles used for breathing and swallowing can become weak. People with existing swallowing or breathing problems have the highest risk.
Drug Interactions
Some medicines may interfere with Botox and cause serious side effects. Tell your doctor about all medications you’re taking.
Important: Check with your doctor if you’re unsure about what medicines, vitamins, or supplements you’re taking and how they might affect Botox.
- Other botulinum toxin products (within last 4 months)
- Injectable antibiotics (gentamycin, tobramycin)
- Muscle relaxants
- Allergy or cold medicines
- Sleep medicines
Alcohol & Driving
Be careful with activities that require alertness until you know how Botox affects you.
Driving and Operating Machinery
Be careful driving or operating machinery until you know how Botox injection affects you.
Storage
Botox is an injectable medicine that will only be provided to you by your healthcare practitioner in a clinic setting. No home storage is required.
Overdose Information
If you think you or anyone else may have swallowed or accidentally injected Botox, immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital. Do this even if there are no signs of discomfort. You may need monitoring for several days for signs of muscle weakness. An anti-toxin exists but is only effective if given within 30 minutes after injection. Tell your doctor if you feel general weakness, local muscle weakness, or difficulty breathing or swallowing in the weeks following injection.
Frequently Asked Questions
The time varies by condition: muscle spasms typically improve within 1-3 days with maximum effect in 1-2 weeks, bladder conditions improve within 2 weeks, chronic migraine effects develop over time with treatment every 12 weeks, and cosmetic treatments show improvement within 1-2 weeks.
Duration varies by treatment: muscle conditions typically last 3-4 months, overactive bladder lasts 5-6 months, neurogenic bladder lasts 8-10 months, excessive sweating effects vary, and cosmetic treatments last 4-6 months depending on the area treated.
Yes, you can have repeat treatments when effects wear off, but timing restrictions apply: most conditions require at least 3 months between treatments, chronic migraine is treated every 12 weeks, and excessive sweating treatments should be at least 4 months apart.
Tell your doctor about all medical conditions, especially muscle disorders, breathing problems, swallowing difficulties, heart problems, and any medications you’re taking including blood thinners, muscle relaxants, antibiotics, and sleep medicines.
Botox use during pregnancy or breastfeeding is not recommended. Tell your doctor if you become pregnant while being treated or if you are breastfeeding or planning to breastfeed.
Seek immediate medical attention for: muscle weakness, drooping eyelids, vision problems, trouble speaking/swallowing/breathing, chest pain, heart rhythm changes, severe allergic reactions with swelling or breathing difficulty. In children, watch for pneumonia or seizures.
Yes, Botox is approved for children 2 years and older for cerebral palsy-related spasticity, and for children 12 years and older for certain muscle spasm conditions. The maximum dose for children is 8 Units/kg body weight or 300 Units per 3-month period, whichever is lower.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.