Botox and other botulinum toxins have storage conditions specified on their packaging. This ensures that the product is safe and potent when it is used. However, things do not always go as planned. Maybe you mixed up a solution only to have a no-show patient, over-purchased in order to receive a volume discount, or your courier left a box on your doorstep in a heat wave. In these situations, you may find yourself throwing away hundreds of dollars worth of botulinum toxin. What a huge waste!The good news is, research suggests that the manufacturer’s storage recommendations may be far too conservative. A few studies have looked into the effectiveness of different brands of botulinum toxins and found that they are viable long past the times recommended. Knowing this can save you money, reduce waste and help you take advantage of sales and volume discounts when purchasing your medical supplies.
Neurotoxin Botox is the most popular cosmetic injectable in the U.S. and around the world. Clients ask for it by name, and it is not cheap. For small clinics with low volume, even one vial of wasted Botox can be a blow to the bottom line. According to Allergan, its manufacturer, you should always keep Botox in the refrigerator, at 2° C to 8° C, or in the freezer, below 5° C. With a 36-month shelf life from its manufacturing date, this seems simple enough. However, when errors occur, you may be wondering if there is a way to avoid wasting these expensive vials.
Various studies have looked into what happens to Botox when it is exposed to storage conditions outside the normal range. Allergan itself has confirmed that you can use Botox after five days at room temperature, something they fail to mention in their product packaging. Not only that, the product may remain stable even in extreme shipping conditions. When study authors L. Parraga et al. referenced available product information and spoke to manufacturers directly, they found that botulinum toxin remains stable for 14 days at 25° C and 7 days at 30° C. If your package sits at the reception desk overnight, or your refrigerator quits on a long weekend, there is no need to dispose of your Botox. It seems it will be just fine.
Not only does unopened Botox remain stable for longer than expected, and at more extreme temperatures, studies suggest that reconstituted botulinum toxin can be used for much longer than you may think. According to Allergan’s product information, Botox should be used immediately after adding saline, or within 24 hours if stored appropriately. In case of scheduling difficulties or setbacks, it has been shown that reconstituted Botox can be safely used days or even weeks later, with the same initial effectiveness and duration.
Researchers compared the effectiveness of fresh Botox versus solutions that were two hours, six days and one through four weeks old. For their comparison, researched ensured each volunteer received injections of fresh and aged solutiosn in the extensor digitorum brevis muscles of their feet. They found that the two hour old solution was just as effective as the fresh solution, with the four week old solution having statistically similar results.
No matter how old the solution, each was equally effective at relaxing the treated muscle, and the effects lasted just as long.
Other researchers found similar results using older Botox solutions on glabellar lines. When they compared freshly-prepared solution to solution that was up to 43 days old, they found similar results. These studies show that you can save your Botox solution for future use, reducing waste and stretching your budget.
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