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Posted 22nd May 2023

Antibiotics Contraindicated for Toxin Treatments

Antibiotics Contraindicated for Toxin Treatments

As a medical aesthetics professional, it’s important to understand the antibiotics contraindicated for toxin treatments.

Certain antibiotics are contraindicated as they are known to interfere with neuromuscular transmission. These medications could potentially interact with the toxin’s mechanism of action. This primarily involves blocking the release of acetylcholine at the neuromuscular junction.

Correct doses for injecting botox to lift the brows


When taking your patient’s medical history, keep an eye out for antibiotics that are contraindicated.


A group of antibiotics called aminoglycosides is known to exhibit neuromuscular blocking effects. These include gentamicin, neomycin, and streptomycin.

Their usage in conjunction with botulinum toxin treatments can potentiate the muscle relaxant effects. This can lead to an increased risk of muscular weakness or paralysis by strengthening the effects of the toxin.


Another class of antibiotics that may pose contraindications are the fluoroquinolones. These include ciprofloxacin, levofloxacin, and moxifloxacin.

Neuromuscular blocking effects of fluoroquinolones are generally considered to be minimal. That said, there have been rare reports of muscle weakness or respiratory distress in patients who received botox injections while taking these antibiotics.

Antibiotics Contraindicated for Toxin Treatments


Amoxicillin is not contraindicated for botox injections. This is a frequent query as it’s commonly prescribed in the UK to treat conditions such as chest infections and dental abscesses.

As always, however, investigate why your patient is taking this. Also check the most up-to-date patient information before confirming their suitability for treatment. Ultimately, botox is not a need, it’s a want. If a patient is unwell, delaying treatment is always an option.

For example, if the patient has an infection that’s causing them to run a high temperature, they are systemically unwell. This could have a negative effect on their toxin treatment. As such, postponing until they are well is in their best interests.


The potential for interaction between botox and antibiotics may vary depending on such factors as...

  • Specific antibiotic
  • Dosage
  • Duration of treatment
  • Individual patient characteristics
  • Indication for treatment.

A thorough assessment of your patient’s medical history and current medication regimen is crucial before permitting treatment.

Botox technique botulinum toxin

HOW LONG TO WAIT BETWEEN COMPLETING A course of contraindicated antibiotics and toxin treatment

If your patient is completing a course of contraindicated antibiotics, explain the issue to them. Assuming they’re otherwise suitable, you can offer to delay their treatment until they’ve completed the course.

You should allow a period of about a week once they’ve finished the course before their botox appointment. This is to ensure the medication is out of their system. It’s also to allow time for them to recover from their illness. This helps to assure the safety and efficacy of both treatments.

As a medical professional, always consult appropriate guidelines and refer to the latest research, in such cases. You’ll also need to consider individual patient factors when making decisions regarding whether they’re taking antibiotics contraindicated for toxin treatments.

If you’re unsure, you can look up the relevant medication on the Electronic Medicines Compendium.

All information correct at the time of publication.

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