What the FDA labels say about taking them together
Botulinum toxin type a and lidocaine
Botulinum toxin type a's FDA label (Botox Cosmetic) of October 18, 2024 names lidocaine in its warnings and precautions section; the lidocaine labels PlainMeds reads (4) do not name botulinum toxin type a.
Check it at the source: the botulinum toxin type a FDA label on DailyMed (effective July 10, 2026); the lidocaine FDA label on DailyMed (effective May 13, 2024, Fresenius Kabi USA, LLC).
What does the botulinum toxin type a label say about lidocaine?
Botox Cosmetic label (Allergan, Inc., October 18, 2024), warnings and precautionsOne fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent, and consequently the causal agent cannot be reliably determined.
Source: FDA drug label (Botox Cosmetic, BLA103000), Allergan, Inc., effective October 18, 2024 (SPL set 485d9b71-6881-42c5-a620-a4360c7192ab), via openFDA
Source: FDA drug label (Xeomin), Merz Pharmaceuticals, LLC, effective July 10, 2026 (SPL set ccdc3aae-6e2d-4cd0-a51c-8375bfee9458), via openFDA; the full label on DailyMed
What does the lidocaine label say about botulinum toxin type a?
Lidocaine's label (effective May 13, 2024) and its 3 other brand-application labels do not name botulinum toxin type a in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (Xylocaine MPF), Fresenius Kabi USA, LLC, effective May 13, 2024 (SPL set d5e0d06f-ba1e-44d4-aa89-39d6c146dc23), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Botulinum toxin type a | Lidocaine | |
|---|---|---|
| Labeled for | Muscle spasms and spasticity, Migraine, Overactive bladder | Pain |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | n/a | $0.154 per gram 5% ointment |
| Shortage now | No current entry | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once