Peptide Profile: Botulinum Toxin

Botulinum Toxin Dosing Protocol

Botulinum toxin, a neurotoxin produced by Clostridium botulinum, is widely used therapeutically to reduce muscle overactivity and for cosmetic applications. It functions by blocking acetylcholine release at neuromuscular junctions, causing temporary muscle relaxation (Padda, 2023). The dosing protocol varies significantly based on indication, patient size, and prior treatment history. For adult patients receiving onabotulinumtoxinA (Botox), total doses generally should not exceed 400 units within a 3‑month interval, although indication‑specific limits exist (Chiu et al., 2020; Medscape, 2025). Dosing is highly individualized; clinicians start with the minimum effective dose and titrate based on clinical response and adverse events, such as muscle weakness or dysphagia (Shetty et al., 2008; Padda, 2023). In therapeutic uses like spasticity, doses are given per kilogram (e.g., 3–6 U/kg for upper limb), whereas cosmetic injections often involve fixed units per muscle group (e.g., 20 U for glabellar lines) (Healthline, 2025; Medscape, 2025). Burr dosing intervals typically span 3–4 months to optimize outcomes and reduce antibody development. Proper training in reconstitution, injection technique, and patient monitoring is essential for safety and effectiveness.

References

Chiu, S. Y., et al. (2020). High‑dose botulinum toxin therapy. PMC. (PMC)
Healthline. (2025). Botox dosage guide. (Healthline)
Medscape. (2025). Botox dosing per muscle. (Medscape)
Padda, I. S. (2023). Botulinum toxin – StatPearls. (NCBI)
Shetty, M. K., et al. (2008). Guidelines on the use of botulinum toxin Type A. (IJDVL)

Botulinum Toxin Dosing Chart (Typical Examples)

Note: Dosing charts are simplified and clinical practice should follow full prescribing information and clinician judgment.