How long is reconstituted Botox good for?
Allergan's prescribing information says reconstituted BOTOX should be stored refrigerated at 2 to 8 degrees C and administered within 24 hours. Peer-reviewed research tells a longer story: a multicenter double-blind study by Hexsel and colleagues, published in Dermatologic Surgery in 2003, found no difference in efficacy for toxin reconstituted up to six weeks before injection when properly refrigerated. Most practices land somewhere between those two numbers with a written policy set by their medical director, and the policy only protects anyone if every vial's clock is actually tracked.
That last part is where practices fail. Not the science, the tracking.
What the label requires
Three facts from the prescribing information worth pinning to the med room wall:
- Reconstitute with sterile, preservative-free 0.9 percent sodium chloride.
- Store reconstituted vials at 2 to 8 degrees C, refrigerated, not frozen.
- The labeled window is 24 hours. Anything beyond that is a practice-level decision your medical director owns, documented in your policy.
Whatever window your practice sets, the operational question is identical: for any open vial in the fridge, can anyone on the team answer when it was mixed, from which lot, by whom, and how long it has left?
Why the per-vial clock matters
Three reasons, in the order they cost you:
Waste. A 100 unit vial runs 500 to 600 dollars wholesale. A vial mixed Friday and found Monday with no mix date on it is a write-off by default, because nobody can prove it is inside the window. Practices that track mix times stop throwing away product on uncertainty.
Compliance. If your policy says 14 days, an inspector or an attorney will ask how you enforce 14 days. A handwritten date on tape enforces nothing. A per-vial record with a timestamp does.
Recalls. Manufacturer recalls name lot numbers. If the lot is recorded when the vial is mixed, answering which patients received a given lot takes seconds instead of a week of chart archaeology.
How practices track it
The paper version: write the date and time on tape, stick it on the vial, hope the tape survives the fridge. It fails quietly and constantly.
The system version, which is how MedRestock does it: when a provider mixes a vial she taps Mix on that product, types the lot number from the vial label and her initials, and taps Start clock. The vial now has a live countdown visible to the whole team, its lot, and the name of who mixed it. Every dose drawn from it is logged in units with patient and provider initials. When the vial is finished, one tap closes the clock. If it has to be discarded with product left, the remaining units are recorded as waste and priced automatically, so the write-off number at the end of the month is real instead of invisible.
One clinic running this flow logged eight treatments across six patients in a single day, with four vials mixed under two manufacturer lots, every dose attributed to a patient, a provider, and a lot. Their recall answer for either lot is a ten second search.
Does the same apply to Dysport and Jeuveau?
The principle is identical, the numbers differ. Each product's prescribing information carries its own reconstitution and storage guidance, and practices commonly run different discard windows for different toxins. In MedRestock the window is set per product, so Botox can run 14 days while Dysport runs 7, each vial counting down against its own product's rule.
The short version
The label says 24 hours. The literature supports longer under refrigeration. Your medical director sets the policy. And the policy is only as good as the clock on each vial: mix time, lot, initials, countdown, and a waste record when a vial dies early. That is the whole discipline.
If your practice tracks this on tape and memory today, MedRestock runs the clocks, the lots, and the dose log for you, from 49 dollars a month with a 14 day free trial. For the wider picture of running injectable inventory, start with the Botox inventory management guide.