Botulinum toxin


Botulinum toxin is the active ingredient of Botox injection (Nappi code:813850-002).

General information

Botulinum toxin is a nerve toxin, which causes muscle relaxation.

In South Africa it is registered for the treatment of severe eyelid spasms and spastic foot deformities.

Cosmetically it is used to remove facial wrinkles by paralysing muscles under the skin. Botulinum toxin is also used for the treatment of excessive sweating.

This drug should never be self-administered.

How does botulinum toxin work?

Botulinum toxin is a neurotoxin, and prevents nerves from releasing a chemical messenger essential for communication between nerves and muscle cells. As a result the medication prevents nerve stimulation of muscles and causes muscle relaxation. The effect of this toxin lasts for 2 - 3 months until new nerve endings have formed.

Fast facts

Drug schedule: schedule 4

Available as: botulinum toxin is available as injection.

What does it do? Botulinum toxin causes muscle relaxation.

Overdose risk: high

Dependence risk: low

Is botulinum toxin available as a generic? no

Is botulinum toxin available on prescription only? yes

User information

Onset of effect: within a few of days

Duration of action: up to 3 months

Prolonged use: frequent use may make botulinum toxin less effective.

Special precautions

Consult your doctor before using this drug if:

  • you have myasthenia gravis or any other muscle disorder
  • you are takin warfarin or any other anti-coagulant
  • you have epilepsy
  • you have a heart disease

Pregnancy: avoid. Potential risk to the foetus have been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Infants and children: a reduced dose is needed.

The elderly: a reduced dose is needed.

Driving and hazardous work: because this drug may be used in treatment of the eyelid, it may affect your vision. Avoid these activities until you know how this medication affects you.

Possible side effects

Side effectsFrequency
Consult your doctor

CommonRareOnly if severeIn all cases
High fever
Severe skin rash


Drug interactions

neomycinincreased effect of Botulinum toxin
tobramycinincreased effect of Botulinum toxin
gentamycinincreased effect of Botulinum toxin
muscle relaxantsincreased effect of Botulinum toxin


This material is not intended to substitute medical advice, but is for informational purposes only.

Please consult a physician for specific treatment and recommendations.

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