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Updated: May 31, 2026
Functional Evaluation of Biological Neurotoxins in Networked Cultures of Stem Cell-derived Central Nervous System Neurons
Published on: February 5, 2015
Safety and Efficacy of a Multi-use Neurotoxin Protocol in Academic Settings
Michael Shaughnessy1, Alexandra White, Elias Kean
1All authors are affiliated with the Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
Background:
Botulinum neurotoxin (BoNT) is approved as single-use vials containing doses higher than necessary for most patients, which contributes to waste and lost revenue. It is common practice to administer a single-use BoNT vial to multiple patients, but data are lacking to support the safety of this practice.
Objective:
To determine the safety and efficacy of a multiuse vial protocol for BoNT at an academic medical center.
Materials And Methods:
A retrospective review of the electronic medical record identified patients receiving cosmetic BoNT at Oregon Health & Science University between 2020 and 2025. Adverse events that occurred within 30 days of the procedure were recorded.
Results:
A total of 2,666 patients receiving cosmetic BoNT were included. Overall, 354 (13.28%) follow-ups occurred within 30 days, and 39 (1.46%) adverse events occurred. The majority of these were related to inadequate paralysis (16) or asymmetrical paralysis (12). No serious complications or infections were identified.
Conclusion:
Complications when using a multiuse vial policy for BoNT are infrequent and not related to infection. Adoption of similar policies nationwide will lead to a reduction in medical waste and increased revenue.
