Botox is a prescription drug used to reduce wrinkles and treat medical conditions such as overactive bladder and chronic migraine. The drug comes as a powder and is diluted with saline before it’s given as an injection.
Some people may be concerned that the healthcare professional administering their Botox injections is overdiluting the drug (adding too much saline) to make their supply last longer. Yet there aren’t any reliable statistics on how often this may occur. To help make sure this doesn’t happen to you, it’s important to receive Botox from a reputable healthcare professional who is highly rated.
Botox, whether used for medical or cosmetic purposes, always requires dilution with saline before being injected. (The dilution process is also called reconstitution.) Botox requires dilution because it comes as a dry powder inside a vial. The drug must be turned into a liquid solution so it can be injected with a syringe.
The healthcare professional administering Botox will reconstitute the medication by drawing up the proper amount of saline in a syringe and slowly injecting it into the vial of Botox. Then they’ll gently mix it by rotating the vial.
Botox needs to be used within 24 hours once it’s diluted. The mixture should be:
- colorless
- free of solids
- clear
In some cases, the healthcare professional may dilute Botox in front of you. Other times, they may dilute the drug in another room.
What’s the correct dilution amount for Botox?
Botox is diluted with 0.9% saline (often referred to as just “saline” or “normal saline”). The amount of saline added to Botox powder depends on the vial size of Botox and the condition it’s being used for.
For example, if you receive Botox to treat migraine, your healthcare professional will dilute a 200-unit Botox vial with 4 milliliters (mL) of saline. Or they may dilute a 100-unit vial with 2 mL of saline. This gives the reconstituted solution a concentration of 5 Botox units per 0.1 mL.
Botox always needs to be mixed with saline before it can be injected. Overdiluting Botox involves adding more saline to the powder than is necessary. This is unlikely to cause any negative health effects, but it could potentially make the drug less effective.
It’s possible for a healthcare professional to overdilute Botox, whether by accident or on purpose. If you see that a clinic is offering Botox injections significantly cheaper than comparable clinics in your region, it may be a red flag.
Finding a reputable and highly rated professional for your Botox injections can help you make sure that you’re getting the proper dose. An experienced healthcare professional can also properly administer your medication in the right places and at the right depth.
Several types of healthcare professionals can administer Botox. These include:
- doctors
- nurse practitioners
- physician assistants
- registered nurses
- dermatologists
- dentists
Individual states have differing laws on who can administer Botox. You can check the laws in your area to make sure you receive Botox from a licensed healthcare professional.
If you need help finding a qualified healthcare professional who can administer Botox, you can ask your primary care doctor or others on your healthcare team for suggestions. You can also see this article for tips on finding a healthcare professional for cosmetic Botox injections.
Botox comes as a powder that’s diluted with saline before being injected.
Some people may worry that their Botox is being overdiluted. This shouldn’t be a concern if the healthcare professional you’re seeing is highly rated and reputable.
If you’re seeing a plastic surgeon, you can make sure they are board certified by checking the American Society of Plastic Surgeons website. For other types of healthcare professionals, you can visit Healthgrades.com to see how they’ve been rated by other patients. (Healthgrades is a sister site of Healthline.)
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.