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Botox

Pronunciation: Boe-tox
Generic name: onabotulinumtoxinA
Brand name: Botox Therapeutic
Dosage form: single-dose vial (100 units, 200 units)
Drug class: Skeletal muscle relaxants

Medically reviewed by Carmen Pope, BPharm. Last updated on Mar 17, 2025.

What is Botox?

Botox is used to treat chronic migraines, excessive sweating, bladder conditions, eye muscle disorders including strabismus, and other muscle or neck spasms. Tiny amounts of Botox are injected by a healthcare provider into the specific muscles or glands being treated.

This guide covers Botox Therapeutic for medical use. Botox Cosmetic is the form of onabotulinumtoxinA used to improve facial wrinkles and platysma bands.

FDA-approved Botox indications

Botox Therapeutic is used to:

Botox Vs Botox Cosmetic

Although Botox contains the same active ingredient as Botox Cosmetic, they have different FDA approved uses and vial strengths and are not interchangeable.

How quickly does Botox work?

Botox Therapeutic begins relaxing targeted muscles within 24 to 48 hours after injection. Maximum muscle relaxation and full results are seen around 2 weeks after an injection. The effects of Botox gradually wear off after 3 to 9 months as nerve signals recover or nerves regenerate and muscle function returns.

How does Botox work?

Botox is a neurotoxin that temporarily blocks nerve signals to specific muscles or sweat glands. This targeted approach:

Botox wears off with time as new nerve endings sprout and gradually reconnect with muscles or sweat glands, allowing them to work normally again in the treated area.

Botox safety for medical conditions

Botox for medical conditions should only be injected by a trained healthcare provider who can ensure:

Botox side effects

The most common side effects of Botox for medical use are as follows.

At the injection site:

General side effects (these vary depending on the medical condition being treated):

Other common side effects experienced by those being treated with Botox for bladder conditions are:

If you have difficulty fully emptying your bladder after getting Botox, you may need to use disposable self-catheters to empty your bladder up to a few times each day until your bladder can start emptying again.

Most of these side effects are temporary and resolve within a few days to weeks.

Serious side effects and warnings

Rarely, Botox can cause serious side effects that require immediate medical attention. It carries a Boxed Warning for the distant spread of the toxin effect. These problems can happen hours, days, to weeks after an injection.

Spread of toxin effects. In some cases, the effect of botulinum toxin A may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism. The symptoms of botulism include:

These problems could make it unsafe for you to drive a car or do other dangerous activities. There has not been a confirmed serious case of the spread of toxin effect away from the injection site when Botox has been used at the recommended dose to treat chronic migraine, severe underarm sweating, blepharospasm, or strabismus.

Problems swallowing, speaking, or breathing. These problems can happen hours, days, to weeks after an injection of Botox usually because the muscles that you use to breathe and swallow can become weak after the injection. Death can happen as a complication if you have severe problems with swallowing or breathing after treatment with Botox.

Call your healthcare provider or get emergency medical help if you have any of these problems after treatment with Botox:

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Botox. For more information, ask your doctor or pharmacist. Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA1088.

Before taking

It is not known whether medical Botox injections are safe and effective in people younger than:

It is not known whether Botox is safe and effective:

Do not receive Botox if you:

Before receiving Botox, tell your healthcare provider about all your medical conditions, including if you:

Pregnancy

It is not known if Botox can harm your unborn baby.

Breastfeeding

It is not known if Botox passes into breast milk.

How is Botox administered?

Botox is given by a healthcare provider as a series of tiny injections into the affected muscle(s) or skin.

Botox Dosing Information

Your healthcare provider will follow indication-specific dosage and administration recommendations. In a 3 month interval, they should not exceed a total dose of:

The following dosage recommendations are from the Botox Therapeutic Package Insert:

What should I avoid while receiving Botox?

Botox may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of receiving the injection. If this happens, do not drive a car, operate machinery, or do other dangerous activities.

What other drugs affect Botox?

Tell your doctor about all your medicines, including prescription and over-the-counter medicines, vitamins and herbal supplements. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past. Especially tell your doctor if you:

Ask your doctor if you are not sure if your medicine is listed above. Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine.

Botox ingredients

Active ingredient: onabotulinumtoxinA

Inactive ingredients: human albumin and sodium chloride.

Manufacturer

Botox is made by AbbVie, who acquired the previous manufacturer Allergan in 2020. AbbVie is headquartered in North Chicago, Illinois, USA.

Botox Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There are 2 for Botox.

Botox (onabotulinumtoxinA) - AbbVie Inc.
Formulation type Strength
Single-Dose Vial 100 units
Single-Dose Vial 200 units
Single-Dose Vial 50 units Discontinued
Botox Cosmetic (onabotulinumtoxinA) - AbbVie Inc.
Formulation type Strength
Single-Dose Vial 100 units
Single-Dose Vial 50 units

View Botox Cosmetic information in detail.

Popular FAQ

What is Masseter Botox?

Masseter Botox is a procedure where Botox is injected directly into your masseter muscle – this is one of the muscles located on the side of your face that helps you chew. The masseter Botox procedure has become popular recently because it can slim a square face and reshape the jaw line. The cosmetic benefits of this procedure were discovered by accident – the original reason Botox was injected into the masseter muscle was to relieve teeth grinding (also called bruxism) and jaw pain or tension. Continue reading

Where do they inject Botox for migraines?

Botox is injected into 7 specific muscle areas around your head and neck to help prevent migraine headaches before they start. Areas include your forehead, bridge of the nose, temples, neck, back of the head, and just above the shoulder blades in your upper back. Continue reading

Does Botox for migraines also help with wrinkles?

Botox Cosmetic is used for aesthetic purposes for wrinkles and Botox is used as a therapeutic treatment for different medical conditions, including migraine headache prevention. Botox Cosmetic and Botox come as separate products but are both prescription medicines that contain the active ingredient onabotulinumtoxinA. Continue reading

What is Daxxify, the recent FDA-alternative to Botox?

Daxxify (daxibotulinumtoxinA-lanm) is the first Botox alternative that is free of human albumin or animal-based components, and it was FDA-approved in September 2022. It is also the longest-lasting of all the cosmetic injectable wrinkle treatments, lasting for 6 months in most people and 9 months in some. Continue reading

How much does Botox cost?

The cash price for Botox is around $677 to $1,344 for a 100 or 200 unit vial, but you will not pay this price. Most people (80%) pay $0 and may save money on the injection procedure with the Botox Savings Program offered through AbbVie, the manufacturer of Botox. Continue reading

How many units of Botox are used for migraines?

The recommended total dose of Botox (onabotulinumtoxinA) for chronic migraine prevention is 155 Units administered intramuscularly (into the muscle). This is given as 0.1 mL (5 Units) injections per each site divided across 7 specific head/neck muscle areas, for a total of 31 individual injections. Continue reading

Botox Vs Botox Cosmetic: What is the difference?

Botox and Botox Cosmetic are the same drug (onabotulinumtoxinA) made by the same parent company, AbbVie. The key differences are in their FDA-approved uses, marketing, and vial strengths. Continue reading

How does Botox work for migraines?

Botox is a migraine prevention medicine injected into muscles in the head and neck every 12 weeks. It helps to block acetylcholine, a neurotransmitter that carries pain signals. In studies, Botox prevented 8 to 9 headache days a month, compared to 6 to 7 days for patients given a placebo. Continue reading

How long does Botox last for migraines?

Botox when used for migraine prevention lasts about 12 weeks for people who have a good response. You will visit your doctor 4 times per year for your treatment, or as directed. Because you receive treatment every 12 weeks, you won’t have to remember to take a daily pill for migraine prevention. Continue reading

View more FAQ

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.