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Botulinum toxin A (Botox) should be used within 4 hours of reconstitution with preservative-free saline (0.9% NaCl), according to the U.S. Food and Drug Administration (FDA)-approved package insert. However, many clinicians have found that botulinum toxin A maintains its potency for weeks after reconstitution. To keep reconstituted botulinum toxin A beyond 4 hours, using saline that contains preservative would seem prudent. These researchers evaluated saline preparations to see which is least painful to receive by injection.
Twenty patients who had previously received injections of botulinum toxin A reconstituted with preservative-free saline were recruited and injected with botulinum toxin A reconstituted with saline and the preservative be…