How to Dilute Dysport- the new alternative to Botox
June 26th, 2009
Dysport, another form of botulinum toxin Type A, is now in physician’s offices. (Originally it was going to be caled Reloxin but the FDA required it to be called Dysport as it is in Europe).
I get calls every day from doctors who want to know how to dilute Dysport or what the ratio of Dysport units to Botox units is. It can all be found in the second edition of my textbook that just launched called Cosmetic Dermatology (McGraw Hill 2009). In that chapter it describes the differences between Dysport and Botox and shows how to inject Dysport and Botox. You can also find information about Botox at www.derm.net . I have a training program for international fellows that is called “The University of Miami International Cosmetic Dermatology Fellowship”. That information is also at www.derm.net.
At the University of Miami Cosmetic Medicine and Research Institute, we performed the clinical trials that led to FDA approval of Botox and Dysport. We have also worked with the toxin called Myobloc. We received Dysport and began using it on patient on June 17, 2009. This is what I have found so far:
If you dilute the 300 unit vial with 3.5cc of Dysport, it gives you 8.5 units per 0.1cc. I felt that this dose was weaker than 4 units of Botox. It begins working at this dose in about 30 hours. I did not see any difference in diffusion than I do with Botox. I have no idea how long this lasts because I just used it for the first time last week. I treated the first 3 days of patients with this dose but I did n ot feel it was strong enough so I now use this method:
If you dilute the 300 unit vial with 3.0cc of Dysport, it gives you 10 units per 0.1cc. Many doctors in Brazil that use Dysport feel that the ratio of Dysport to Botox is 2.5:1. In other words, 2.5 units of Dysport seems to be equivalent to 1 unit of Botox when used for cosmetic purposes. If the ratio of Dysport to Botox is 2.5:1, then diluting the 300 unit Dysport vial with 3.0cc makes sense. I have found that injecting 10 units per site (in the same areas that I would inject 4 units of Botox) works well. It starts working on the second day in most patients.
Please comment here on your experience. I am most interested to know what you think about how long Dysport lasts.
For those of you who are not physicians, this is the bottom line: Dysport is very similar to Botox except that the results appear sooner. We do not know yet if Dysport lasts longer than Botox. The prices are very similar but now that Botox has some competition, they may come down a little.
