Botulinum Toxin Type A Preventing Complications

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In this article we will discuss ways to prevent complications and adverse reactions with botulinum toxin type A for cosmetic use.

Step 1 know your medicines and how they work?

Botulinum Toxin for Cosmetic Use

There are three commercial brands botulinum toxin type Acurrently available. These are BOTOX, BOCOUTURE and AZZALURE. Please note the units and doses are not transferable with the different brands of botulinum toxin type A for cosmetic.

Understanding the mechanism of action is essential before treating a patient with botulinum toxins. This gives the practitioner the knowledge to understand how the toxin effects the neuromuscular transmission and release of acetylcholine. There are currently 22 major drug interactions with the botulinum toxin for cosmetic and a further 347 moderate interactions(1).

Many potential complications can be reduced by understanding the action of the toxin and any drug that have especially relevant effects on this mode of action.

Medicines that interact with botulinum toxins include:

  • Muscle relaxants/anti-spasmodic
  • Anti-histamines
  • Anti-cholinergic (in many cold and flu medicines)
  • Tricyclic anti-depressants

The British National Formulary ( and are a good resource for information about medicines.

Consequently the patient medical history must include questions regarding any medicine the patient has been taking prior to the treatment. The practitioner must identify any potential drug interactions and review further information then provide guidance. Most of all proceed with caution some medicines such as muscle relaxants and anti-spasmodic drugs are deemed absolute contraindications.

The next article we will review medical conditions that are contraindicated or have cautions associated with the treatment of botulinum toxin type a. In addition you can subscribe at the foot of this page to receive updates about aesthetic medicine.