My doctor does not refrigerate the Botox bottle when it arrives in her office. At times, she has left it at room temperature for over a week.She has told me that it only needs to be refrigerated after it is reconstituted. I am having problems with it working. Does un-opened Botox need to be refrigerated?
My doctor does not refrigerate the Botox bottle?
Question posted by The Odie Factor on 4 Jan 2011
Last updated on 12 November 2014
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3 Answers

According to the monographs Botox powder needs to be kept in the refrigerator. It also needs to be kept in the fridge after it is reconstituted, and the contents discarded after 4 hours, once reconstituted.
"Storage of Botox)
Parenteral
Powder for Injection (Botox and Botox Cosmetic)
2–8°C; do not use after expiration date marked on vial.
Following reconstitution in single-use vials with 0.9% sodium chloride injection without preservatives, store at 2–8°C and use within 4 hours. Do not freeze.
Vials may be reentered to treat the same patient within 4 hours of reconstitution; store at 2–8°C during this time.1 5 298 Discard any remaining solution.
Absolutely right!
contrary to popular believe new studies have indicated that there is no need to refrigerate un-reconstituted botox. however, reconstituted botox needs to be refrigerated. additionally, efficacy of re-constituted botox is still effective up 6 months of reconstitution. thus discarding after 4 hours will be a waste.
Botox definately needs to be refrigerated before being reconstituted. The pharmacy where I purchased it said that it needed to be kept frozen, but the doctor office said that only refrigerated--for how long I don't know.
Your doctor is being negligent in not refrigerating it. And that explains why it isn't working for you. And judging by your doctor not knowing to refrigerate it, who knows what other areas your current doctor may not be knowledgeable in treating you. Get another doctor!!!
Get it from only from a reputable pharmacy if not from a decent doctor which yours is not. If you call around, you should be able to find one, if it makes the procedure less expensive. But your health insurance should cover it since the FDA approved it for migraines in Oct. 2010.
read below. this one of many studies...
PubMedSearchClick to search
Questioning the need to use Botox within 4 hours of reconstitution: a study of fresh vs 2-week-old Botox.
Authors
Yang GC1, Chiu RJ, Gillman GS.
Author information
Journal
Arch Facial Plast Surg. 2008 Jul-Aug;10(4):273-9. doi: 10.1001/archfaci.10.4.273.
Affiliation
Abstract
OBJECTIVE: To determine whether injection with botulinum toxin type A (Botox; Allergan Inc, Irvine, California) reconstituted with preservative-free saline (0.9% isotonic sodium chloride) after 2-week cold storage in a refrigerator (4 degrees C) or freezer (-20 degrees C) is less efficacious than injection with freshly reconstituted Botox.
METHODS: We conducted a prospective, double-blind, randomized controlled trial at an academic facial plastic surgery practice with 40 volunteers for treatment of horizontal forehead rhytids, each acting as his or her own control. In a blinded fashion each subject received freshly reconstituted Botox (control) on one side of the forehead (frontalis muscle) and 2-week-old reconstituted Botox (experimental) stored at 4 degrees C (refrigerated) or stored at -20 degrees C (frozen) on the other side. The right and left forehead movement was measured and photographed at rest and during maximum contraction of the frontalis muscle prior to Botox administration and on follow-up days 14, 30, 60, 90, and 120 after injection. Each participant also completed a questionnaire regarding right and left forehead movement prior to injection and at each follow-up visit.
RESULTS: No significant difference was noted for any subject in the timing of onset or duration of action or the measurable reduction of forehead movement between the fresh and 2-week-old refrigerated Botox or between the fresh and 2-week-old frozen Botox. The subjects had a gradual return of muscle function over the 4-month follow-up period.
CONCLUSIONS: No measurable difference was found in the potency or duration of efficacy of Botox in the treatment of forehead rhytids after 2 weeks of refrigeration or freezing compared with fresh reconstituted Botox. When Botox, fresh or stored, is given at an adequate dose to cause full paralysis of the desired muscle, the duration of the muscle paralysis is dependent on the physiologic rate for the motor nerve to reestablish neural transmission.
PMID 18645097 [PubMed - indexed for MEDLINE]
Silverchair Information Systems: Full text
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If you want I can sell you refrigerated vials of Botox for inexpensive, that you can bring to your medical professional for a lessened price, and more effective treatment.
Are they frozen or refrigerated?
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Further information
- Botox uses and safety info
- Botox prescribing info & package insert (for Health Professionals)
- Side effects of Botox (detailed)
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