Botox Vs Xeomin: Differences Worth Knowing

Botox and Xeomin are basically Neurotoxins that work by affecting the nervous tissue; and thus, are known to work in a similar way. Botox, the brand name for OnabotulinumotoxinA, is used to treat various medical conditions other than its popular use, for smoothing facial wrinkles. Xeomin, the brand name for IncobotulinumtoxinA, is a newer product that is similar to Botox. However; they are quite different from each other in several ways. Botox needs to be kept either frozen or refrigerated.

However, Xeomin can be kept at room temperature, before reconstitution. Keep reading this post to know more about the differences between Botox and Xeomin.

Botox Vs Xeomin

Botox Vs Xeomin: Differences Worth Knowing

There are certain disorders, which can be treated with Botox. Some of them include, severe underarm sweating, cervical dystonia, a neurological disorder that results in severe neck and shoulder muscle contractions, blepharospasm, uncontrollable blinking, misaligned eyes, strabismus, chronic migraine, and overactive bladder. Xeomin is also used for treating all these disorders.

Botox Vs Xeomin: Basic Differences

Botox is made from the toxin that is produced by the bacterium Clostridium botulinum. This is the toxin that causes botulism or a life-threatening type of food poisoning. Botox belongs to a class of drugs known as Neurotoxins and it is used for treating various medical conditions, the most popular one being the temporary smoothing of facial wrinkles.

Xeomin is a Botulium toxin type A that is produced from fermentation of Hall strain Clostridium botulinum serotype A. This is also a Neurotoxin and is relatively a newer product. Like Botox; Xeomin is also mainly used for the temporary smoothing of facial wrinkles.

Botox Vs Xeomin: Differences Based On How They Work

Coming to the way how these two work; both Botox and Xeomin are given as a number of tiny injections. Botox weakens or paralyzes muscles near the injected site by blocking certain nerves, while Xeomin relaxes the muscles near the site of injection by blocking the release of a chemical called Acetylcholine. There is no muscle response, when the nerves command the muscle to contract. Wrinkles are basically caused due to the contraction of the muscles; injecting a neurotoxin relaxes the muscles, resulting in a reduced level of wrinkles.

Though the effects of Botox last 3-12 months, depending on what is being treated, the effects of Xeomin last 3-6 months.

Botox Vs Xeomin: Differences Based On Their Effectiveness

Botox and Xeomin are very similar. But, Botox acts faster and takes between 4-7 days to take its effects; while Xeomin might take upto 2 weeks to take effect. Botox also lasts longer upto one year; while Xeomin lasts a maximum upto 6 months. They exhibit the same diffusion pattern.

One primary difference between the two is that Botox mixes the Clostridium botulinum molecule with proteins, while Xeomin contains no bonding albumin protein, keeping the molecules pure. This in turn results in fewer allergic reactions. One more advantage of Xeomin is that, unlike Botox, it can be kept at room temperature before reconstitution.

Botox Vs Xeomin: Differences Based On Precautions That One Must Follow While Using

Patients considering Botox, should provide their detailed medical history to the doctor. Muscle or nerve conditions like, amyotrophic lateral sclerosis or ALS, myasthenia gravis or Lambert-Eaton syndrome, should especially be maintained. Apart from this, patients should also provide details about bleeding problems, history of seizures, hyperthyroidism, or any lung or heart disease.

Patients considering Xeomin, should mention about their bleeding problems, heart disease, dysphagia, seizures, and breathing issues such as Asthma emphysema or aspiration-type Pneumonia. They must also inform about muscle or nerve disorders, such as Lou Gehrig’s disease, Myasthenia gravis, Lambert-Eaton syndrome or any history of seizures.

Botox Vs Xeomin: Differences Based On Risks And Side Effects

Both, Botox as well as Xeomin can diffuse from the site of injection and affect muscles other than the ones targeted. With this, the muscles that control breathing and swallowing can be affected. In such case, patients may develop severe problems in swallowing or breathing, and these effects may last for several months or may even cause the patient’s death. Those patients who have difficulty swallowing, may require to be fed through a feeding tube so as to avoid getting food or drink into the lungs.
Some of the most common side effects of Botox include pain, swelling or bruising at the site of injection, headache, neck, bone and muscle pain, dry mouth, tiredness, constipation, nausea, anxiety, dry or irritated eyes, problems in falling asleep or staying asleep. Some of the rare but severe side effects of Botox may include double, blurred or reduced vision, swelling of eyelids, difficulty moving the face, irregular heartbeat, seizures, inability to empty bladder, pain or burning while urinating or frequent urination.

Some of the common side effects of Xeomin are, pain or tenderness at the site of injection, dry mouth, headache, neck, bone and muscle pain, diarrhea, tiredness, reduced blinking. Some of the rare, yet severe side effects of Xxeomin include changes in vision, swelling of eyelids, eye pain and eye irritation, neck pain, itching, shortness of breath and fainting.

Botox Vs Xeomin: Differences Based On Allergic And Overdose Reaction

Patients may show an allergic reaction to Botox. Symptoms of such allergic reactions include itching, rash, red and itchy welts, symptoms of asthma, wheezing, dizziness or feeling faint.

Symptoms of allergic reactions to Xeomin are, dizziness, rash, hives, itching and swelling of the feet, hands, ankles and lower legs.

It must be noted that symptoms of overdose for both, Botox as well as Xeomin, are the same and include, severe muscle weakness, breathing problems and paralysis.

Botox Vs Xeomin: Differences Based On The Drug Interaction

Botox may interact with drugs such as, certain antibiotics like Aminoglycosides, gentamicin and Polymyxin; anticoagulants such as Warfarin, drugs for Alzheimer’s disease, such as donepezil, Galantamine, Rivastigmine and Tacrine; Mysathenia gravis drugs, like Ambenonium and Pyridostigmine, and Quinidine.

Xeomin may interact with specific antibiotics, such as Amikacin, Colistimethat, Clindamycin, Gentamicin, Lincomycin, Kanamycin, Neomycin, Polymyxin, Streptomycin and Tobramycin; anticoagulants; cholinesterase inhibitors like, ambenonium, donepezil, neostigmine, galantamine, physostigmine, pyridostigmine, rivastigmine, and tacrine; magnesium sulfate, medicines for colds, allergies, or sleep; muscle relaxants; and quinidine.


With all that we read above, it must be clear that Botox and Xeomin are the neurotoxins that work is similar way, yet have some of the most noted differences. Kindly note to consult thoroughly with your doctor before considering any of these neurotoxins; and also do not forget to provide a detailed information about your health and medical history to your doctor.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:December 14, 2018

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