Onabotulinumtoxina: uses, dosing, side effects & brands
Onabotulinumtoxina is a medicine sold in the U.S. under 2 brand and generic names, for blepharospasm, dystonia and fissure in ano. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Treats
- Blepharospasm, Dystonia and Fissure in Ano
- Available as
- Injectable
- Sold as
- 2 products — Botox and Botox Cosmetic
- Prescription?
- Prescription only
- Generic available?
- Not in our catalog
- Boxed warning
- Boxed warning
How onabotulinumtoxina is dosed
From the FDA label for Botox (application BLA103000). Other onabotulinumtoxina products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Glabellar Lines Administration: 0.1 mL (4 Units) into each of 5 sites, for a total dose of 20 Units ( 2.4 ) Lateral Canthal Lines Administration: 0.1 mL (4 Units) into each of 3 sites per side (6 total injection points), for a total of 24 Units ( 2.4 ) Forehead Lines Administration: 0.1 mL (4 Units) into each of 5 forehead line sites (20 Units) with 0.1 mL (4 Units) into each of 5 glabellar line sites (20 Units), for a recommended total of 40 Units ( 2.4 ) Platysma Bands Administration: 0.05 mL (2 Units) into each of 4 sites in the upper segment of the platysma muscles, below the jawline on each side and 0.025 mL (1 Unit) into 5 sites on each vertical neck band per side (1 to 2 bands per side) for a total of 26 Units, 31 Units, or 36 Units (18, 23, or 28 injection sites, respectively) ( 2.4 ) BOTOX Cosmetic is administered by intramuscular injection ( 2.2 ) Follow dosage and administration recommendations. Do not exceed the maximum recommended cumulative dose in a treatment session for any indication ( 2.1 , 2.2 ) See Preparation and Reconstitution Instructions for information on BOTOX Cosmetic reconstitution, storage, and preparation before injection ( 2.3 ) Figure 1: Figure 2 and 3 Figure 4: Figure 5: Injection Sites for Platysma Prominence (2 Bands) Figure 6: Injection Sites for Platysma Prominence (1 Band) 2.1 Instructions for Safe Use The potency Units of BOTOX Cosmetic…
Onabotulinumtoxina side effects
The following adverse reactions to BOTOX Cosmetic (onabotulinumtoxinA) for injection are discussed in greater detail in other sections of the labeling: Spread of Toxin Effects [see Warnings and Precautions ( 5.2 )] Hypersensitivity [see Contraindications ( 4.1 ) and Warnings and Precautions ( 5.4 )] Dysphagia and Breathing Difficulties [see Warnings and Precautions ( 5.7 )] The most common adverse reactions are ( 6.1 ): Glabellar Lines: eyelid ptosis (3%) Lateral Canthal Lines: eyelid edema (1%) Forehead Lines: headache (9%) and brow ptosis (2%) To report SUSPECTED ADVERSE REACTIONS, contact AbbVie at 1-800-678-1605 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, the adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. BOTOX and BOTOX Cosmetic contain the same active ingredient in the same formulation, but have different labeled Indications and Usage. Therefore, adverse events observed with the use of BOTOX also have the potential to be observed with the use of BOTOX Cosmetic. In general, adverse reactions occur within the first week following injection of BOTOX Cosmetic and while in many cases are transient, may have a duration…
Who shouldn’t take onabotulinumtoxina
Hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation ( 4.1 , 5.4 ) Infection at the injection site ( 4.2 ) 4.1 Known Hypersensitivity to Botulinum Toxin BOTOX Cosmetic is contraindicated in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation [see Warnings and Precautions ( 5.4 )] . 4.2 Infection at the Injection Site(s) BOTOX Cosmetic is contraindicated in the presence of infection at the proposed injection site(s).
Onabotulinumtoxina drug interactions
No formal drug interaction studies have been conducted with BOTOX Cosmetic (onabotulinumtoxinA) for injection. Patients receiving concomitant treatment of BOTOX Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like agents), or muscle relaxants, should be observed closely because the effect of BOTOX Cosmetic may be potentiated ( 7 ) 7.1 Aminoglycosides and Other Agents Interfering with Neuromuscular Transmission Co-administration of BOTOX Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. 7.2 Anticholinergic Drugs Use of anticholinergic drugs after administration of BOTOX Cosmetic may potentiate systemic anticholinergic effects. 7.3 Other Botulinum Neurotoxin Products The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin. 7.4 Muscle Relaxants Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX Cosmetic.
Every onabotulinumtoxina product we track (2)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 72/100 | Prescription | Injectable | No data | — | View → | |
| 2 | 72/100 | Prescription | Injectable | No data | — | View → |
How long onabotulinumtoxina keeps
No onabotulinumtoxina label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does onabotulinumtoxina expire? The in-use limits and storage rules from its labelsWhat people report to the FDA about onabotulinumtoxina
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 194 reports naming onabotulinumtoxina, and the FDA flagged 70% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- headache15 reports
- fatigue12 reports
- constipation11 reports
- urethral haemorrhage11 reports
- paraesthesia10 reports
- raynaud^s phenomenon10 reports
- nausea9 reports
- muscular weakness8 reports
Read these as a signal, not a rate. A report does not mean onabotulinumtoxina caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved July 25, 2026.
Related calculators
Frequently asked questions
What is onabotulinumtoxina?
Botox (Onabotulinumtoxina) is a medication used to treat Blepharospasm, Dystonia, Fissure in Ano, Muscle Rigidity.
Can you take onabotulinumtoxina with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run onabotulinumtoxina against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is onabotulinumtoxina sold under?
We track 2 onabotulinumtoxina-containing products in the U.S.: Botox and Botox Cosmetic. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does onabotulinumtoxina come in?
Across the brands we track, onabotulinumtoxina is currently marketed as injectable, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic onabotulinumtoxina?
We do not currently list a generic-labelled onabotulinumtoxina product. That does not always mean none exists — it means none appears under a generic name in the FDA data we track. Ask your pharmacist.
Cite this page
- APA
- pharmaranks. (2026, July 24). Onabotulinumtoxina: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/onabotulinumtoxina
- MLA
- “Onabotulinumtoxina: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/onabotulinumtoxina.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for onabotulinumtoxina on DailyMed (NIH) ↗ — including its boxed warning in full.