Botox

(onabotulinumtoxinA)

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Prevents headaches in people with chronic migraines and treats various other problems such as muscle spasms, wrinkles, and excessive sweating.

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Our bottom line

Botox (onabotulinumtoxinA) is a prescription medicine that's good at treating many conditions, but it has potentially dangerous side effects.

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Quick facts about Botox
  • Drug class: Musculoskeletal
  • Rx status: Prescription only
  • Generic status: No lower cost generic available

Upsides

  • Botox (onabotulinumtoxinA) can prevent migraines before they even start.
  • Since Botox (onabotulinumtoxinA) only prevents migraines, you can continue to take other medicines to lower pain once a migraine has already started, unless your doctor has given you other instructions.
  • You may start to feel results in a few days to a few weeks, depending on what you're using it for.
  • Botox (onabotulinumtoxinA) isn’t a daily or weekly medication. Depending on your condition, you only need to take it every couple months.
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What to expect from Botox, on one page

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Downsides

  • Only comes as an injection.
  • Botox (onabotulinumtoxinA) works by weakening your muscles, which can cause swallowing, speaking, or breathing problems. Tell your doctor if you already have these problems before injection. If you develop these problems after injection, call your doctor or go to the emergency room right away.
  • If you take Botox (onabotulinumtoxinA) for chronic migraines, it’s unknown if it’s safe or will work for adults who have 14 or fewer headache days each month.
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How it works

Botox (onabotulinumtoxinA) is a toxic protein made by bacteria (Clostridium botulinum type A). It works by temporarily weakening nerve activity in the muscle for up to several months.

Quick facts about Botox
  • Drug class: Musculoskeletal
  • Rx status: Prescription only
  • Generic status: No lower cost generic available

Used for

  • Chronic migraines
  • Excessive sweating
  • Neck muscle spasms

Dosage forms

  • Injection
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Prices and coupons

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What to expect when you take Botox (onabotulinumtoxinA) for Chronic migraines

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  • First few hoursHours
    First few daysDays
    First few weeksWeeks
    First few monthsMonths
  • Effectiveness
  • Full effects
  • First few hoursHours
    First few daysDays
    First few weeksWeeks
    First few monthsMonths
  • Possible side effects
  • Neck pain
  • Muscle weakness
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Side effect rates for Botox (onabotulinumtoxinA)

From 1379 clinical trials of Botox when taken for chronic migraines (155 - 195 units)
  • Neck pain
    9%9%
    3%3%
  • Headache
    5%5%
    3%3%
  • Migraine
    4%4%
    3%3%
  • Drooping eyelids
    4%4%
  • Stiffness in bones, joints, muscles
    4%4%
    1%1%
  • Muscle weakness
    4%4%
  • Bronchitis
    3%3%
    2%2%
  • Muscle pain
    3%3%
    1%1%
  • Pain in bones, joints, muscles
    3%3%
    1%1%
  • Injection site pain
    3%3%
    2%2%
  • Facial paralysis
    2%2%
  • Muscle spasms
    2%2%
    1%1%
  • High blood pressure
    2%2%
    1%1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Where we got our data »

The placebo bar shows how common a side effect was for people taking a sugar pill instead of Botox.

Botox (onabotulinumtoxinA)
Placebo

People taking Botox felt side effect more

People taking Botox felt side effect less

No difference

Risks and Warnings for Botox (onabotulinumtoxinA)

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    • Higher risk if:
    • › Child using Botox (onabotulinumtoxinA) for spasticity
    • › Using Botox (onabotulinumtoxinA) for uncontrollable neck spasms
    • › Adult using Botox (onabotulinumtoxinA) for spasticity

    Botox (onabotulinumtoxinA) toxin can spread from the area of injection to cause a serious condition called botulism. This can happen hours to weeks after an injection. Symptoms of botulism include weakness, double vision, drooping eyelids, trouble swallowing, slurred speech, loss of bladder control, and breathing difficulties. If this occurs, tell your doctor right away.

    This is a black box warning. The FDA requires this warning when there is a significant risk of serious or life-threatening effects that anyone taking the drug should consider.

Means that some groups have a high risk of experiencing this side effect

Common concerns from people taking Botox (onabotulinumtoxinA)

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Interactions
  • People taking Botox (onabotulinumtoxinA) for an overactive bladder might develop a urinary tract infection, or be unable to completely empty their bladder. Tell your doctor if you have trouble urinating, painful urination, or burning with urination.