Botox Storage Temperature: How to Store Neurotoxins
Every neurotoxin label says how to store the unopened vial, and how long the product can be kept once it's reconstituted. They don't all say the same thing. Here is what each current US label says, side by side, and how to keep the fridge that holds them in range.
Checked against the sources below on .
Storage by product, from the labels
| Product | Unopened vials | After reconstitution |
|---|---|---|
| Botox Cosmetic (onabotulinumtoxinA) | Refrigerator, 2 to 8 °C (36 to 46 °F) | Refrigerator, 2 to 8 °C; administer within 24 hours |
| Dysport (abobotulinumtoxinA) | Refrigerator, 2 to 8 °C; protect from light | Refrigerator in the original container, protected from light; use within 24 hours; don't freeze |
| Xeomin (incobotulinumtoxinA) | At or below 25 °C (77 °F); refrigeration not required | Refrigerator, 2 to 8 °C, for up to 24 hours |
| Jeuveau (prabotulinumtoxinA) | Refrigerator, 2 to 8 °C, in the carton to protect from light | Refrigerator in the carton; discard 24 hours after reconstitution |
| Daxxify (daxibotulinumtoxinA) | Room temperature 20 to 25 °C, or refrigerator 2 to 8 °C, in the carton | Refrigerator, protected from light; administer within 72 hours; don't freeze |
| Letybo (letibotulinumtoxinA) | Refrigerator, 2 to 8 °C, in the carton; don't freeze | Refrigerator in the carton; administer within 24 hours; don't freeze |
Summarised from each product's US prescribing information. Labels change, so the current package insert always has the final word. Product names are trademarks of their owners.
What this means day to day
- Most neurotoxins, including Botox Cosmetic, go in a medication refrigerator at 2 to 8 °C (36 to 46 °F) as soon as they arrive.
- Xeomin and Daxxify can be stored unopened without refrigeration, within the temperatures on their labels. Once reconstituted, every product in the table goes in the fridge.
- The clock starts at reconstitution: 24 hours for most products, 72 hours for Daxxify. Write the time on the vial and in your reconstitution record.
- Several labels ask you to keep vials in the original carton to protect them from light, so don't unpack them into a fridge tray.
Keeping the toxin fridge in range
A refrigerator that holds neurotoxins should be checked and logged every workday. CDC's vaccine storage guidance, the standard most clinics follow for medication fridges, is to check and record the minimum and maximum temperatures at the start of each workday and keep the logs for 3 years. A digital data logger with a probe records the temperature between checks, including nights and weekends.
- Use a medication or purpose-built fridge. CDC says never to use dorm- or bar-style fridges with a freezer compartment inside, because they can freeze product.
- Keep food and drinks out. Opening the door for lunch changes the temperature.
- Don't store product directly under cooling vents, in the drawers or on the door shelves: CDC's vaccine guidance warns against all three.
If a vial was stored out of range
- Don't use it and don't throw it away yet. Label it "Do not use" and put it back at the right temperature.
- Write down the temperature, the time, and how long it may have been out of range.
- Call the manufacturer. They can tell you whether that product is still usable after that excursion.
- Record what you did in your temperature log's action column, and tell your medical director.
Questions
What temperature should Botox be stored at?
The Botox Cosmetic label says to store unopened vials in a refrigerator at 2 to 8 °C (36 to 46 °F), and to keep reconstituted product in the refrigerator at the same temperature and administer it within 24 hours.
How long is reconstituted Botox good for?
The Botox Cosmetic label says to administer it within 24 hours of reconstitution, stored in a refrigerator. Dysport, Xeomin, Jeuveau and Letybo also say 24 hours; Daxxify says 72 hours.
Can Botox be left out of the fridge?
Botox Cosmetic's label calls for refrigeration, so an unopened vial left out is a temperature excursion. Set it aside, don't use it, and ask the manufacturer whether it's still usable. Xeomin and Daxxify are the exceptions whose labels allow unopened storage outside the fridge.
Can you freeze Botox?
The current Botox Cosmetic label only lists refrigerator storage. Letybo's label says not to freeze unopened vials, and the Dysport, Daxxify and Letybo labels say not to freeze the reconstituted product. Follow the label of the product you have.
Sources
- DailyMed, Botox Cosmetic prescribing information
- DailyMed, Dysport prescribing information
- DailyMed, Xeomin prescribing information
- DailyMed, Jeuveau prescribing information
- DailyMed, Daxxify prescribing information
- DailyMed, Letybo prescribing information
- CDC, Vaccine Storage and Handling Toolkit
General guidance, not legal or medical advice. Requirements vary by state; follow your medical director and product labels.