Daxxify
Daxxify (daxibotulinumtoxinA or daxibotulinumtoxinA-lanm) is an FDA-approved medication for adults to temporarily improve the appearance of frown lines (wrinkles between your eyebrows and in your forehead). It's also used to treat cervical dystonia (muscle spasms in the neck). This medication is injected into the muscles by a trained healthcare provider. Common side effects include headache and pain at the injection site. Daxxify seems to last longer than other botulinum toxin injections (e.g., Botox).
What is Daxxify?
What is Daxxify used for?
Temporary improvement in the appearance of moderate-to-severe frown lines (glabellar lines) in adults
Neck spasms (cervical dystonia) in adults
How Daxxify works
Daxxify is a neuromuscular blocker. It's a toxin made from bacteria (Clostridium botulinum) that temporarily lowers muscle activity by blocking nerve signals that cause muscles to contract (tighten). This helps relax the muscles that cause frown lines and neck spasms.
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What are the side effects of Daxxify?
Common Side Effects
- Headache (6%)
- Injection site reactions (e.g., pain, redness, swelling; 6%)
- Drooping eyelids (2%)
- Trouble moving parts of the face (1%)
- Headache (7-9%)
- Injection site reactions (e.g., pain, redness; up to 8%)
- Upper respiratory tract infection (up to 5%)
- Muscle weakness (2-5%)
- Muscle and bone pain (4%)
- Trouble swallowing (2-4%)
- Spine pain (2-3%)
Other Side Effects
- Joint pain
- Urinary tract infection
Serious Side Effects
- Trouble breathing or swallowing
- Serious allergic reaction: swelling in the lips, tongue, or face; shortness of breath; hives
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dryness or irritation of the eyes, eye pain, change in vision, sensitivity to light
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Spread of botulinum toxin effects—unusual weakness or fatigue, blurry or double vision, trouble swallowing, hoarseness or trouble speaking, trouble breathing, loss of bladder control
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Eyelid drooping
- Headache
- Muscle weakness
- Pain, redness, or irritation at injection site
Pros and cons of Daxxify
Pros
Works well to improve the look of frown lines
Can last for up to 6 months or longer for moderate-to-severe frown lines
Injected directly into the muscles causing your condition to help them relax
Given by a trained healthcare provider
Cons
Injections can be painful
Can cause headache and muscle weakness
Requires repeat injections since effects are temporary
Brand only
Pharmacist tips for Daxxify
Before you get your Daxxify injections, your provider might ice the area or apply some numbing cream. This will help lessen discomfort from the injections.
The area(s) where your provider injected Daxxify into might be red, tender, or swollen. This should get better within a few hours or days. Contact your provider if you have any concerns.
When using for frown lines: You might have dry eyes after your Daxxify treatment session. Consider using lubricating eye drops to ease the discomfort.
Avoid driving a car or performing activities that require good vision and muscle strength if you notice problems with your muscles or vision (such as blurry vision or droopy eyelids) after you get your Daxxify injections.
Rarely, Daxxify can cause vision problems. Talk with your provider right away if you notice eye pain or changes in your vision, such double vision or light sensitivity.
Though rare, it's possible for Daxxify to spread beyond the original injection site. This can lead to serious side effects, such as muscle weakness, double vision, trouble swallowing, and breathing problems. These side effects can happen hours to weeks after the injection, so look out for these side effects after you go home. Call your provider right away if you have these symptoms.
If you need a repeat treatment of Daxxify, you'll need to wait at least 3 months in between each session. Getting Daxxify more often than recommended can raise your risk of serious side effects such as breathing problems or muscle weakness. Talk with your provider if you have questions about how often you can get treated.
Frequently asked questions about Daxxify
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What are the risks and warnings for Daxxify?
Daxxify can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Spread of toxin effects
Risk factors: History of muscle, eye, or lung conditions
Although no serious reports with Daxxify have been made, the medication has the potential to spread to other body areas outside of the injection site and cause toxic effects. These effects can potentially happen hours to weeks after the injection. Serious side effects can include unexplained muscle weakness, drooping eyelids, blurred or double vision, trouble breathing or swallowing, slurred speech or trouble speaking, or the need to urinate more frequently. Seek medical help right away if you notice any of these side effects.
Allergic reaction
Allergic reactions, including anaphylaxis, are possible with Daxxify. Get medical help right away if you have shortness of breath, hives, fever, or swelling after you get treated with Daxxify.
Worsening of certain conditions
Risk factors: History of certain muscle-nerve conditions | History of heart problems | Inflammation (swelling) at the injection site
In people with certain medical conditions, Daxxify can make symptoms worse and cause serious side effects.
Some people who used botulinum toxin products like Daxxify have reported heart problems including heart attack and arrhythmias (racing heart). In addition, people with certain muscle-nerve conditions (e.g., myasthenia gravis) might have a higher risk of serious side effects from the medication, including muscle weakness anywhere in the body; blurry vision; drooping eyelids; and trouble speaking, eating, drinking, or breathing. Seek medical help right away if you have any of these side effects.
Make sure to discuss your full medical history with your provider before you use Daxxify. You should also let your provider know if you have any redness or swelling at the areas where you'll be getting the injections or if you currently have drooping eyelids or muscle weakness. Daxxify might worsen these symptoms.
Difficulty swallowing or breathing
Risk factors: History of swallowing or breathing problems | Current muscle-nerve conditions
Daxxify can cause problems with swallowing or breathing by weakening the muscles involved in these functions. Sometimes, these problems can be life-threatening. Problems with swallowing or breathing can happen hours to weeks after you get Daxxify and can last for many months. Your risk is higher if you have certain conditions affecting your muscles or nerves. Tell your provider if you have a history of swallowing or breathing problems before you start treatment. And seek medical help right away if you notice any problems with swallowing or breathing after you get your injections.
Reduced blinking, dry eye, and vision changes (when used for frown lines)
Daxxify can cause dry eyes when the medication is used for temporarily improving frown lines. In addition, people who've used botulinum toxin products like Daxxify have reported making less tears and blinking less often. Talk to your provider if you have eye irritation, sensitivity to light, or visual changes that don't go away.
Daxxify dosage forms
Typical dosing for Daxxify
Daxxify is only available as an intramuscular (IM) injection that's administered by a healthcare provider.
Frown lines: The typical recommended dose per treatment session is 40 units (divided into 5 smaller doses) injected into the affected muscles.
Neck spasms: The typical dose ranges from 125 units to 250 units, given as divided doses and injected into the affected muscles.
How much does Daxxify cost?
Daxxify contraindications
Infection at injection site
What are alternatives to Daxxify?
Temporary improvement in the appearance of moderate-to-severe frown lines (glabellar lines) in adults
Neck spasms (cervical dystonia) in adults
Frown lines
Crow's feet
Forehead lines
Neck lines
Temporary improvement in moderate-to-severe frown lines (glabellar lines) in adults
What is the latest news about Daxxify?
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References
Best studies we foundBertucci, V., et al. (2019). DaxibotulinumtoxinA for Injection has a prolonged duration of response in the treatment of glabellar lines: Pooled data from two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). Journal of the American Academy of Dermatology.
Carruthers, J. D., et al. (2020). DaxibotulinumtoxinA for injection for the treatment of glabellar lines: Results from each of two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). Plastic and Reconstructive Surgery.
Jankovic, J., et al. (2018). Injectable DaxibotulinumtoxinA in cervical dystonia: A phase 2 dose-escalation multicenter study. Movement Disorders Clinical Practice.
Revance Therapeutics Inc. (n.d.). About Daxxify®.
Revance Therapeutics, Inc. (2023). U.S. FDA approves first therapeutic indication for Revance’s Daxxify® (DaxibotulinumtoxinA-lanm) for injection for the treatment of cervical dystonia. Business Wire.
Revance Therapeutics, Inc. (2024). Daxxify- botulinum toxin type a injection, powder, lyophilized for solution [package insert]. DailyMed.
Solish, N., et al. (2021). Overview of DaxibotulinumtoxinA for injection: a novel formulation of botulinum toxin type A. Drugs.
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