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This medication may spread to other areas of the body after injection, potentially causing serious, even fatal, side effects. These effects can occur from hours to weeks following the injection. Although the risk of such severe side effects is minimal when using this medication for conditions like migraines, skin issues (such as wrinkles), eye spasms, or excessive sweating, it is crucial to understand the potential risks. Children treated for muscle stiffness or spasms face the highest risk, as well as individuals with certain pre-existing medical conditions. It is important to discuss the benefits and risks with your healthcare provider.

• Seek immediate medical attention if you experience serious side effects such as chest pain, difficulty breathing, significant muscle weakness, irregular heartbeat, severe difficulty swallowing or speaking, or a loss of bladder control.
• Potential for toxin spread: The medication has been associated with spreading beyond the injection site, causing toxic side effects. Symptoms may include unexplained muscle weakness, droopy eyelids, blurry or double vision, breathing or swallowing difficulties, slurred speech, or increased frequency of urination. Contact a healthcare provider immediately if these symptoms occur.
• Swallowing and breathing difficulties: There is a risk of severe complications that may affect your ability to swallow or breathe, particularly in those with existing muscle or nerve conditions, or when injected into specific muscles. If you have a history of such problems, inform your healthcare provider prior to receiving this treatment.
• Eye complications: Injections into the eyelid muscles may reduce blinking and lead to eye issues such as ulcers. Those with a history of eye surgery or nerve problems should be monitored, and protective measures like ointments or special lenses may be recommended.
• Glaucoma risk: The medication may exacerbate certain types of glaucoma by increasing eye pressure. Disclose any history of glaucoma to your healthcare provider.
• Drooping eyelids: Using this medication for frown lines may lead to drooping eyelids, especially if used more frequently than every three months or at higher doses. Notify your healthcare provider if this occurs.

Contraindications: This medication should not be used if there is an infection at the injection site. Discuss any concerns with your healthcare provider before starting treatment.

When using this medication, some common side effects may occur, which are usually mild and temporary. These include redness, bruising, infection, and pain at the injection site. You might also experience dizziness, mild difficulty swallowing, respiratory infections such as cold or flu, nausea, headache, or muscle weakness. Other possible effects are back pain, dry mouth, diarrhea, high blood pressure, and trouble speaking. Eye-related side effects may include double vision, drooping or swollen eyelid, eye irritation, dry eyes, tearing, reduced blinking, and increased light sensitivity.

For those using the medication to prevent migraines, headaches, neck pain, and drooping eyelids are possible. When addressing excessive sweating, non-underarm sweating, respiratory infections, headache, fever, neck or back pain, and anxiety might occur. If treating overactive bladder, be aware of potential urinary tract infections, burning or painful urination, fever, or difficulty urinating.

Though rare, some serious side effects require immediate medical attention. These include severe allergic reactions such as itching, swelling, rash, severe dizziness, or trouble breathing. Additionally, trouble swallowing, nervous system problems, severe neck pain, infections, breathing difficulties, and significant muscle weakness are also considered serious. If any of these effects persist, worsen, or cause concern, seek medical advice promptly.