Consensus statement regarding storage and reuse of previously reconstituted neuromodulators

Murad Alam*, Diana Bolotin, Jean Carruthers, Doris Hexsel, Naomi Lawrence, Kira Minkis, Edward Victor Ross

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


BACKGROUND: Legacy recommendations suggest that vials of botulinum toxin be used within 24 hours of reconstitution and in a single patient. Current standard of care is consistent with storage after reconstitution and use of a single vial for several patients. OBJECTIVE: To develop expert consensus regarding the effectiveness and safety of storage and reuse of botulinum toxin. MATERIALS AND METHODS: The American Society for Dermatologic Surgery authorized a task force of content experts to review the literature and provide guidance. Data extraction was followed by clinical question review, a consensus Delphi process, and validation of the results by peer review. RESULTS: After 2 rounds of Delphi process, the task force concluded by unanimous consensus and with the highest level of confidence that a vial of toxin reconstituted appropriately can, for facial muscle indications, be (1) refrigerated or refrozen for at least 4 weeks before injection without significant risk for contamination or decreased effectiveness and (2) used to treat multiple patients, assuming appropriate handling. CONCLUSION: The standard of care, which allows for use of botulinum toxin more than 24 hours after reconstitution and in more than 1 patient per vial, is appropriate and consistent with the safe and effective practice of medicine.

Original languageEnglish (US)
Pages (from-to)321-326
Number of pages6
JournalDermatologic Surgery
Issue number3
StatePublished - Mar 15 2015

ASJC Scopus subject areas

  • Surgery
  • Dermatology


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