Reconstitution / Dilution

    When BTX is received by the end user it is in a freeze dried state and needs to be reconstituted. In the case of Botox the bottle appears to be empty when received. Close inspection reveals a circular, fine white powder residue on the bottom of the vial. The BTX is reconstituted with a sodium chloride (NaCl) solution (salt water). There are different regiments used for the reconstitution. In the case of Botox the current recommendation from Allergan, the manufacturer, is to use 1ml of NaCl to reconstitute the bottle which contains 100 unit of BTX. This is known as a 1:1 dilution meaning that for each 1ml there are 100 units of BTX. In the past, when Botox was first released, the recommendation was to use 4 ml of NaCl to reconstitute the bottle. Known as 4:1 dilution there would be 100 units of BTX to each 4ml. In this case if an area called for 20 units of BTX a larger volume of the solution would have to be used to yield the same results. A 4:1dilution would need 0.8 ml to equal 20units while a 1:1 solution would need only 0.2 ml injected. With more solution being injected there could be more discomfort, longer resolution time for swelling and a question about the spread of the BTX under the skin to other sites. It is important to understand that the word dilution, whether 1:1 or 4:1 or other has nothing to do with your dosing or the strength of the product. If you need 20 units you will still get 20 units but the amount of the injected product will change based on the dilution. There are many people that say they know someone that dilutes BTX. All products must be reconstituted at some dilution this does not mean the product is weaker or less effective or that it will last a shorter period of time.