How To Reduce Your Risks When Providing Botulinum Toxin

Carolyn Buppert


Dermatology Nursing. 2008;20(6):473-474,492. 

In This Article


Based on the cases, reports, FDA communication, and manufacturer instructions, here are some guidelines for avoiding the risks associated with Botox.

  • Use the appropriate form of botulinum toxin.

  • Use the dose approved for the indication.

  • Use the medication for approved indications. Cosmetic indications currently include glabullar lines associated with the corrugator and/or procerus muscle activity in adult patient less than 65 years old.

  • Screen patients for medical problems, pregnancy, breastfeeding, and infection at the site. Administer the medication only to patients who are not pregnant or breastfeeding, are not infected, and who are free of multiple medical problems. Consider declining to provide the medication to patients with nerve or muscle illnesses or complaints.

  • Take a medication history and decline to administer the medication to individuals who are on the antibiotics gentamicin, tobramycin, clindamycin, and lincomycin. Consider declining to administer the medication to individuals on heart medications such as quinidine, and to individuals on medication for myasthenia gravis, or Alzheimer's disease.

  • Inform patients regarding possible side effects.


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