Botox interactions: Alcohol, medications, and other factors

Botox interactions with other medications  

Before you start treatment with Botox, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Botox interacts with supplements, herbs, or vitamins, see the “Botox and other interactions” section.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Botox. Keep in mind that this table doesn’t include all drugs that may interact with Botox. Some of these interactions are described in detail in the “Drug interactions in depth” section.

When to avoid Botox

In some cases, factors or conditions could prevent your doctor from prescribing Botox due to the risk of harm. These are known as contraindications. The contraindications of Botox include:

Having an infection in the area of injection

Doctors typically won’t prescribe Botox for people who have an infection in the area they’re planning to have the drug injected. This is because Botox can irritate the area and worsen the infection.

If you have an infection at the planned injection site, talk with your doctor before your Botox treatment. They’ll likely postpone your Botox treatment until your infection gets better.

Having had an allergic reaction to Botox or any of its ingredients

If you have had an allergic reaction to Botox or any of its ingredients, your doctor will likely not prescribe Botox. Treatment with the drug could cause another allergic reaction. You can ask them about other treatments that may be better for you.

Note: Before you start treatment with Botox, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Botox.

Having a urinary tract infection or urinary retention

If you’re receiving Botox injections for bladder problems, your doctor likely won’t prescribe them if you have a urinary tract infection (UTI) or difficulty completely emptying your bladder. This is because Botox can worsen your infection and your ability to empty your bladder.

If you have a UTI, your doctor will wait until it gets better to start Botox treatment. If you have difficulty emptying your bladder, talk with your doctor about whether Botox is safe for you.

Botox interaction with alcohol

There aren’t any known interactions between Botox and alcohol. However, if you drink alcohol, your doctor may advise you to avoid or limit it during Botox treatment.

This is because drinking alcohol during treatment with Botox may worsen some of the drug’s side effects. For example, you may experience:

• nausea
• headache
• dizziness
• fatigue
• blurry vision

If you drink alcohol during Botox treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol during Botox treatment, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Botox.

Certain antibiotics

Aminoglycosides are a type of antibiotic used to treat infections.

Interaction result: Taking an aminoglycoside antibiotic during Botox treatment can increase the effects of Botox.

Interaction explained: Botox works by blocking nerve signals that cause muscles to contract. As a result, your muscles will relax. Aminoglycosides also interfere with these nerve signals. So taking an aminoglycoside with Botox injections can strengthen the effects of Botox, specifically muscle weakness.

Examples of aminoglycoside drugs: Here are some aminoglycosides that may interact with Botox:

• amikacin (Amikin)
• gentamicin (Garamycin)
• tobramycin (Tobrex)

Steps you or your doctor may take: Before starting any antibiotics, tell your doctor if you receive Botox injections. They can help determine whether it’s safe to use these medications together. They can also discuss alternative antibiotics that don’t interact with Botox.

Anticholinergics

Anticholinergics are used to treat various medical conditions, including urinary incontinence, chronic obstructive pulmonary disease, and overactive bladder.

Interaction result: Taking an anticholinergic during Botox treatment can increase the risk of side effects from the anticholinergic drug.

Interaction explained: Anticholinergic drugs work by reducing the effects of acetylcholine. When taken alone, anticholinergics can cause side effects such as blurry vision, dry mouth, constipation, and drowsiness. Similarly, Botox blocks the release of a chemical messenger, or neurotransmitter, called acetylcholine. Using these drugs together can significantly worsen these side effects.

Examples of anticholinergic drugs: Here are some anticholinergics that may interact with Botox:

• oxybutynin (Ditropan)
• scopolamine (Transderm Scop, others)
• diphenhydramine (Benadryl, others)

Steps you or your doctor may take: If you take an anticholinergic drug, tell your doctor before you start Botox treatment. They can help determine whether it’s safe to use these medications together. If you and your doctor decide that you’ll use these medications together, they can discuss potential ways to minimize side effects.

Muscle relaxants

Muscle relaxants are used to treat muscle spasms or muscle tightness.

Interaction result: Combining muscle relaxants with Botox treatment can cause excessive muscle weakness.

Interaction explained: Botox works by blocking nerve signals that generally cause muscles to tighten (contract). By blocking these signals, muscles relax. Muscle relaxers work similarly, so combining muscle relaxants and Botox can result in excessive muscle weakness.

Examples of muscle relaxant drugs: Here are some muscle relaxers that may interact with Botox:

• cyclobenzaprine (Fexmid)
• metaxalone (Skelaxin)
• carisoprodol (Soma)
• tizanidine (Zanaflex)
• methocarbamol (Robaxin)
• baclofen (Lioresal)

Steps you or your doctor may take: Be sure to tell your doctor if you take a muscle relaxant before you start Botox injections. During Botox treatment, your doctor will likely monitor you closely for symptoms of severe muscle weakness. These may include difficulty breathing, swallowing, or talking.

Botox and other interactions

Botox may have other interactions, such as with supplements, foods, vaccines, or lab tests. Keep in mind that the following information does not include all other possible interactions with Botox.

Botox interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Botox interactions with herbs

There are no specific reports of herbs interacting with Botox. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Botox treatment.

Botox interactions with vitamins

There are no specific reports of vitamins interacting with Botox. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Botox.

Botox interactions with food

There were no reports of food interactions with Botox. If you’d like to learn more about eating certain foods during treatment with Botox, talk with your doctor.

Botox interactions with vaccines

There aren’t any known interactions between Botox and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Botox interactions with lab tests

Botox isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

BOTOX INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Botox. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Botox. The impact of cannabis may affect how well you stick to your Botox treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Botox and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Botox. Before you take this drug, be sure to talk with your doctor about your health history. Botox may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Botox include:

• Urinary tract infection or urinary retention: If you’re receiving Botox injections for bladder problems, your doctor likely won’t administer injections if you have a UTI or problems emptying your bladder.
• Skin infection at the planned injection site: Your doctor likely won’t prescribe Botox if you have a skin infection in the area where you’re planning to receive injections. They’ll likely wait until your infection has cleared up before they start Botox treatment.
• Neuromuscular condition: If you have a medical condition that affects your muscles and nerves, such as amyotrophic lateral sclerosis (ALS) or myasthenia gravis, your risk of certain Botox side effects may be higher. These side effects may include muscle weakness, difficulty breathing, swallowing, or speaking, and droopy eyelids. Be sure to tell your doctor if you have a neuromuscular condition before you start Botox treatment. They can help determine whether Botox is safe for you.
• Problems swallowing, speaking, or breathing: Botox may spread from the area where it’s injected. This can result in botulism, which can cause difficulty swallowing, speaking, or breathing. If you have any of these problems, let your doctor know before you start Botox.
• Planned surgery: Certain medications used during surgeries can interact with Botox and increase your risk of side effects from Botox. Let your doctor know that you’re receiving Botox injections if you have a surgical procedure coming up. They can help determine whether it’s safe for you to receive Botox around the time of your procedure.
• Allergic reaction: If you’ve had an allergic reaction to Botox or any of its ingredients, your doctor will likely not prescribe Botox. Treatment with the drug could cause another allergic reaction. You can ask them about other treatments that may be better for you.
• Breastfeeding: It’s not known whether Botox treatment is safe while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Botox may have on a child who is breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor before Botox treatment. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether treatment with Botox is safe while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Botox. They can advise you on the right treatment plan for you.

FAQ about Botox and interactions

Here are some frequently asked questions about Botox and possible interactions.

Is there an interaction between Botox and melatonin?

No. There are no specific reports of Botox interacting with melatonin (an over-the-counter sleep aid).

However, both Botox and melatonin can sometimes cause nausea, dizziness, or headaches. You may have an increased risk of these side effects if you take melatonin during Botox treatment. If you’re interested in taking melatonin, you should check with your doctor first.

What antibiotics interact with Botox?

Botox may interact with certain antibiotics, including aminoglycosides. Taking an aminoglycoside antibiotic during Botox treatment can increase the muscle-weakening effects of Botox. To learn more, see the “Drug interactions in depth” section.

If you have more questions about antibiotic use with Botox, talk with your doctor.

Preventing interactions

You can take certain steps to help prevent interactions with Botox. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Botox label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Botox doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Botox by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.