Botulinum toxin  or botox is a drug that can be used to reduce facial wrinkles, treat chronic migraines, muscle stiffness, or overactive bladder . In addition, botox is also used in the treatment of cervical dystonia , excessive sweating (hyperhidrosis) in the armpits, or eye twitching.

Botox comes from the bacterial neurotoxin Clostridium botulinum which can relax or paralyze muscles by blocking the flow of nerve signals. The effects of botox injections are only temporary.

The effects of Botox will generally decrease and disappear after 3-6 months, so another injection is needed. Keep in mind that botox does not cure the disease, but only relieves complaints.

Botox trademarks:  Botox, Lanzox, Xeomin

What is Botox

group Prescription drug
Category muscle relaxer
Benefit Reducing facial wrinkles, treating crossed eyes, chronic migraines, cervical dystonia , excessive sweating in the armpits, twitching , muscle stiffness, or overactive bladder
Used by Mature
Botox for pregnant and lactating women Category N:  Not yet categorized. It is not known whether botox can be absorbed into breast milk or not. For breastfeeding mothers, consult a doctor before using this drug.
Drug form Inject

Precautions Before Using Botox

Before using this drug, you need to pay attention to the following points:

  • Do not use botox if you are allergic to this drug. Tell your doctor about any history of allergies you have.
  • Tell your doctor if you have a skin infection. Botox injections should not be done on skin that is infected or injured.
  • Tell your doctor if you have a urinary tract infection, urinary incontinence, amyotrophic lateral sclerosis (ALS) , Lambert-Eaton syndrome, myasthenia gravis , asthma,  emphysema , seizures , diabetes , difficulty swallowing, facial muscle weakness, or a blood clotting disorder .
  • Tell your doctor if you have had or have recently had facial surgery.
  • Tell your doctor if you have had Botox injections in the past 4 months.
  • Tell your doctor that you are using Botox if you are having surgery, including dental surgery.
  • Tell your doctor if you are taking certain medications, supplements, or herbal products.
  • Tell your doctor if you are pregnant, planning to become pregnant, or are breastfeeding.
  • See your doctor right away if you have an allergic reaction to the drug, a serious side effect, or an overdose after using Botox.

Dosage and Rules for Using Botox

The dose of botox prescribed by a doctor can be different for each patient. The following are common doses for using Botox for adults based on the condition you want to treat:

  • Conditions:  Wrinkles or  wrinkles  on the face. The
    dose is 4 units per injection point, in 3–5 areas of wrinkles on the face.
  • Condition: Chronic migraine
    The dose is 155 units, divided into 7 injection points on the head and neck.
  • Condition: Muscle stiffness The
    dose is 75–400 units, divided into several injection points on stiff muscles. The maximum dose is 50 units at each injection point.
  • Conditions: Cervical dystonia
    . The dose is 198–300 units, divided into several injection points into the affected muscle. Maximum dose of 50 units at each injection point.
  • Condition: Excessive sweating in the armpits ( hyperhidrosis )
    The dose is 50 units in each armpit, divided evenly in several injection points.
  • Condition: Eyelid twitching ( blepharospasm )
    The dose is 1.25–2.5 units in each of the muscles around the eye. The dose can be increased if necessary. The maximum dose is 5 units per area.
  • Condition: Crossed eyes
    Initial dose of 1.25–2.5 units, in each eyeball muscle. Maximum dose of 25 units per area.
  • Conditions: Uncontrolled urination ( overactive bladder )
    The dose is 100 units divided into 20 injections, each injection containing 5 botox units, into the bladder muscle.

If your child is advised to inject Botox, discuss it again with the doctor about the benefits and risks.

How to Use Botox Correctly

Botox will be given directly by a doctor or medical officer under the supervision of a doctor. The drug will be injected into the muscle (intramuscular / IM) as recommended by the doctor.

You are advised to avoid consuming alcohol for at least 1 week before the injection procedure. To prevent bruising, you should also stop taking aspirin and blood-thinning medications 2 weeks before treatment.

Botox injections can be given to more than one area, depending on the patient's condition. If a Botox injection is given to the eye muscles, the doctor may suggest using eye drops, ointment, special contact lenses, or other tools to protect the surface of the eye.

If you are having Botox injections to deal with excessive sweating, it is advisable to shave your armpit hair and not use deodorant or perfume the day before the injection. Do not exercise and consume hot or spicy food or drinks half an hour before the injection.

The time it takes for the effects of Botox to be seen significantly can vary from person to person. In general, the effects are visible within a few days and will last for 3 months.

Avoid rubbing the newly injected area for 24 hours.

Repeat the injection every 3 months or as directed by your doctor to maintain the effect of Botox. It is recommended to do botox injections with the same doctor. If there are changes, inform the condition and frequency of botox injections beforehand, so that the administration of botox injections can be adjusted.

Interactions of Botox with Other Drugs

The following are drug interaction effects that can occur if Botox is used with other drugs:

  • Increased risk of side effects, including excessive muscle weakness, difficulty breathing, or difficulty swallowing, if used with amikacin, colistin , gentamicin, polymyxin B , muscle relaxant medications, such as atracurium, pancuronium , or cisatracurium
  • Increased risk of side effects, such as dry mouth or blurred vision, when used with amitriptyline , amoxapine, atropine , chlorpromazine, or clozapine

Side Effects and Dangers of Botox

Some mild side effects that may occur after using Botox are:

  • Headache , dizziness, or neck pain
  • Pain, redness, bruising, or swelling, at the injection site
  • Flu or cold which can be characterized by symptoms such as nasal congestion , sneezing, fever, chills, or sore throat
  • Difficult to swallow

Consult a doctor if the side effects above do not subside immediately or get worse. You need to see a doctor immediately if you experience an allergic drug reaction or more serious side effects, such as:

  • drooping or drooping eyelids, swollen eyelids, double vision, dry eyes , or more sensitivity to light, if Botox is injected in the forehead area or around the eyes
  • Urinary tract infection , pain or burning sensation when urinating, or pain when urinating, if Botox is used to treat overactive bladder
  • Severe muscle weakness in the non-injected site
  • Chest pain or an abnormal heartbeat  , for example, too fast, too slow, or irregular
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