Neurotoxin Comparison Table: FDA-Approved Uses
Here is how five FDA-approved botulinum toxin brands compare, based on the indications in each product's current FDA prescribing information on DailyMed. Onset, longevity and price vary by patient, dose and clinic, so ask your injector about those for your own treatment plan.
Licensed prescribers may use these products off-label, but an off-label use should not be advertised as FDA-approved.
| Toxin Brand | Active Ingredient | FDA-Approved Cosmetic Use (Label) | Other FDA-Approved Uses (Label) |
|---|---|---|---|
| Botox Cosmetic | OnabotulinumtoxinA | Moderate to severe glabellar (frown) lines, lateral canthal lines (crow's feet), forehead lines and platysma bands | None listed on the Botox Cosmetic label |
| Dysport | AbobotulinumtoxinA | Moderate to severe glabellar lines in adults under 65 years of age | Cervical dystonia in adults; spasticity in patients 2 years of age and older |
| Daxxify | DaxibotulinumtoxinA-lanm | Moderate to severe glabellar lines in adults | Cervical dystonia in adults |
| Xeomin | IncobotulinumtoxinA | Moderate to severe glabellar lines, horizontal forehead lines and lateral canthal lines in adults | Chronic sialorrhea and upper limb spasticity in patients 2 years of age and older; cervical dystonia and blepharospasm in adults |
| Jeuveau | PrabotulinumtoxinA-xvfs | Moderate to severe glabellar lines in adults | None: the label states it is not approved for any conditions other than glabellar lines |
Why Units Do Not Convert Between Brands
Per-unit prices for different brands cannot be compared directly. Each label says so in its own words: Botox Cosmetic units 'cannot be compared to nor converted into' units of other botulinum toxin products, Dysport's potency units 'are not interchangeable with other preparations of botulinum toxin products,' and the Xeomin, Jeuveau and Daxxify labels carry equivalent statements. Ask for the total cost of your treatment plan rather than comparing unit prices.
What changes the total: the brand, the number of units your injector plans for each area, how many areas you treat, who injects, and whether follow-up visits or packages are included. See how much Botox costs in Chicago and what Chicago med spa pricing actually looks like.
Duration, Formulation and Safety Claims, Checked
Ask what any duration claim for Daxxify is based on. In SAKURA-2, a Phase 3 trial sponsored by Revance Therapeutics, the median time until frown lines returned to moderate or severe on both investigator and patient ratings was 167 days, about 24 weeks (ClinicalTrials.gov NCT03014635). A median is the midpoint across trial participants, not a promise for any one patient.
If an injector recommends Xeomin because of how it is formulated, for example by suggesting it reduces the risk of antibody resistance over time, ask what published evidence supports that at cosmetic doses.
If an injector recommends one brand because it spreads more or less, ask what that is based on. All five labels carry a boxed warning that the effects of botulinum toxin products may spread from the area of injection, and that swallowing and breathing difficulties can be life threatening.
None of the five labels lists masseter, jaw slimming, teeth grinding or TMJ use, and none includes the lips, so masseter Botox and a lip flip are off-label with any of these brands.
Frequently Asked Questions
Why is a Dysport unit priced differently from a Botox unit?
Because their units are not the same measure. The Dysport label states its potency units 'are not interchangeable with other preparations of botulinum toxin products,' and the Botox Cosmetic label says its units cannot be compared to or converted into units of any other botulinum toxin product. A per-unit price for one brand therefore cannot be set against another; compare the total quoted cost for the same treatment plan instead.
Can I switch between Botox and Dysport?
Ask your injector whether switching suits you. Because units do not convert between brands, your injector should plan the new brand's dose on its own terms rather than reuse your old unit count.
Is any of these neurotoxins FDA-approved for jaw slimming or a lip flip?
No. None of the FDA labels for Botox Cosmetic, Dysport, Xeomin, Jeuveau or Daxxify lists masseter, teeth grinding or TMJ use, or includes the lips. See masseter Botox in Chicago and lip flip vs lip filler.
Sources
- BOTOX Cosmetic (onabotulinumtoxinA) prescribing information, DailyMed, U.S. National Library of Medicine
- DYSPORT (abobotulinumtoxinA) prescribing information, DailyMed, U.S. National Library of Medicine
- XEOMIN (incobotulinumtoxinA) prescribing information, DailyMed, U.S. National Library of Medicine
- JEUVEAU (prabotulinumtoxinA-xvfs) prescribing information, DailyMed, U.S. National Library of Medicine
- DAXXIFY (daxibotulinumtoxinA-lanm) prescribing information, DailyMed, U.S. National Library of Medicine
- A Phase 3, Randomized, Double-Blind, Placebo Controlled, Multi-Center Trial to Evaluate the Efficacy and Safety of DaxibotulinumtoxinA for Injection to Treat Moderate to Severe Glabellar Lines (SAKURA-2), ClinicalTrials.gov, U.S. National Library of Medicine