BOTOX® is a prescription medicine that is injected into the bladder muscle and used to treat leakage of urine (incontinence) in adults 18 years and older with Overactive Bladder due to neurologic disease who still have leakage or cannot tolerate the side effects after trying an anticholinergic medication.

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Symptoms of overdose are likely not to be present immediately following injection. Should accidental injection or oral ingestion occur or overdose be suspected, the person should be medically supervised for several weeks for signs and symptoms of systemic muscular weakness which could be local, or distant from the site of injection see Boxed Warning and Warnings and Precautions ( 5.2 , 5.6 ). These patients should be considered for further medical evaluation and appropriate medical therapy immediately instituted, which may include hospitalization.

Clinical trial results show that this parallel group study met its primary efficacy endpoint of clinical equivalence, defined as ≥ 1-point improvement from baseline on the Facial Wrinkle Scale (FWS) at maximum frown, 1 month after a single treatment. Similar efficacy and tolerability profiles were demonstrated between the two treatment groups at all timepoints (1, 2, 3 and 4 months post-treatment). The most common adverse events seen in both treatment groups were headache, infection and facial asymmetry.

Managing spasticity with Botox is an ongoing process, and initially, injections are required approximately every three months. The length of treatment depends on the patient’s response and the severity of the spasticity. Some spasticity patients need injections every three months while others receive injections less frequently, once or twice per year. Patients can also improve so much that they no longer need the injections and can continue with physical therapy alone,” Dr. Kosa said.

One or both eyebrows pop up too much. With bad Botox, one or both eyebrows are elevated so much that the arch or the last third of the eyebrow sits up too high, giving the patient a chronically surprised look. In addition, odd wrinkles can occur over the lateral brow. Usually this can be prevented or fixed easily with a few strategically placed drops, if it happens.