AbobotulinumtoxinA (Dysport): uses, dosing, and side effects
Last updated September 6, 2026.
AbobotulinumtoxinA (brand name Dysport) is a prescription botulinum toxin type A injection, a neuromuscular blocking agent that a trained clinician injects into specific muscles. It blocks the release of acetylcholine at the nerve endings that tell a muscle to contract, so the injected muscle relaxes for about 3 to 4 months until new nerve endings form. The most important safety point is in the boxed warning: the toxin effect can spread beyond the injection site hours to weeks later and cause swallowing or breathing problems, which can be life threatening, so any new trouble swallowing, speaking, or breathing after an injection needs immediate medical attention.
What does it treat?
AbobotulinumtoxinA is FDA approved for cervical dystonia in adults, where the neck muscles pull the head into a twisted or tilted position and cause neck pain; for spasticity in adults, covering both upper limb patterns such as a clenched fist, bent wrist, and flexed elbow, and lower limb patterns such as a stiff knee and an inward turned foot; for spasticity in children 2 years and older, including dynamic equinus foot deformity (toe walking) from cerebral palsy; and for temporary improvement of moderate to severe glabellar lines, the vertical frown lines between the eyebrows, in adults under 65. It is a single-ingredient product with no combination forms. Units of abobotulinumtoxinA are not interchangeable with units of onabotulinumtoxinA (Botox), incobotulinumtoxinA (Xeomin), prabotulinumtoxinA (Jeuveau), or daxibotulinumtoxinA (Daxxify), so the dose cannot be carried over if you switch products.
How do you take it?
It comes as a powder in 300 Unit and 500 Unit single-dose vials that your clinician mixes with preservative-free saline and injects into the target muscles, sometimes with ultrasound or electromyography guidance. For glabellar lines the adult dose is 50 Units total, given as five separate 10 Unit injections, repeated no more often than every 3 months. For cervical dystonia the usual starting dose is 500 Units total divided among the affected neck muscles, with later sessions ranging from 250 to 1000 Units. For adult spasticity the label allows up to 1000 Units per upper limb treatment and up to 1500 Units for lower limb treatment, and the total for any one adult session must not exceed 1500 Units. Children treated for spasticity are dosed by weight, and the total per session must not exceed 30 Units per kg or 1000 Units, whichever is lower. Treatments are spaced at least 12 weeks apart for every use. There are no food or drink restrictions because it is not swallowed. There is no missed dose to make up: if you miss an appointment, call to reschedule, and do not have injections sooner than 12 weeks after the last set. Call your doctor right away if you develop new muscle weakness away from the injection site, trouble swallowing, a change in your voice, or drooping eyelids, and hold off on any further injections until you are evaluated.
Side effects to know
- Common: Common effects include soreness, bruising, redness, or swelling where you were injected, along with headache, temporary weakness in nearby muscles, dry mouth, tiredness, and cold or sinus symptoms, and for neck injections some difficulty swallowing or a hoarse voice in the first weeks.
- Serious: Get medical help right away for trouble swallowing, choking on food or liquids, slurred or weakened speech, shortness of breath, double or blurred vision, drooping eyelids, loss of bladder control, or widespread muscle weakness, since these can mean the toxin effect has spread beyond the injection site. An allergic reaction with hives, wheezing, swelling of the face, lips, or throat, dizziness, or fainting is also an emergency, and no further injections should be given until you are evaluated.
Who should not take it?
You should not receive abobotulinumtoxinA if you have had an allergic reaction to any botulinum toxin product, if you are allergic to cow's milk protein (the product contains lactose derived from milk), or if there is an infection at the planned injection site. Talk with your doctor first if you have myasthenia gravis, Lambert-Eaton syndrome, ALS, or another motor neuropathy, since these conditions raise the risk of severe swallowing and breathing problems; if you have swallowing trouble, aspiration, or lung disease already; if you have had surgery or an injury near the injection area; or if you have had eye surgery or a problem with your cornea blinking closed. Tell the injector about aminoglycoside antibiotics such as gentamicin or tobramycin, muscle relaxants and curare-like agents, anticholinergic medicines, and any botulinum toxin injection in the past 3 months or 4 months, because these can add to muscle weakness. There are no adequate data on use in pregnancy, and it is not known whether the toxin passes into human milk, so tell your doctor if you are pregnant, planning pregnancy, or breastfeeding and decide together. The label does not list an alcohol interaction, but alcohol close to the appointment can make bruising more likely.
When is it an emergency?
Call 911 in the US if you have trouble breathing, choking, collapse, sudden widespread weakness, or signs of anaphylaxis such as throat swelling, wheezing, hives, or fainting after an injection. Call 911 or go to an emergency department for new trouble swallowing, drooling, a weak or disappearing voice, drooping eyelids with double vision, or loss of bladder control, which can start hours to weeks after treatment and are the reason the drug carries a boxed warning about distant spread of toxin effect. If too much was injected, or if anyone swallows or is otherwise exposed to the product, call Poison Control at 1-800-222-1222 for guidance; symptoms of an excessive dose may not appear for days, so medical monitoring for several weeks is standard.
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Common questions
What is the maximum dose of abobotulinumtoxinA?
For adults, the total dose in a single treatment session must not exceed 1500 Units. Within that ceiling, upper limb spasticity treatment goes up to 1000 Units and lower limb treatment up to 1500 Units. Cervical dystonia is usually 500 Units total to start, with later sessions between 250 and 1000 Units. Glabellar lines use 50 Units, given as five 10 Unit injections. Children treated for spasticity are capped at 30 Units per kg of body weight or 1000 Units per session, whichever is lower, and every use requires at least 12 weeks between sessions.
Can I drink alcohol after an abobotulinumtoxinA injection?
The FDA label does not list an interaction between abobotulinumtoxinA and alcohol. Many injectors still suggest skipping alcohol for about 24 hours before and after treatment because alcohol widens blood vessels and makes bruising at the injection site more likely. Alcohol also causes muscle weakness and drowsiness of its own, which can make it harder to tell whether a new symptom is coming from the injection. If you notice weakness, swallowing trouble, or vision changes after drinking, do not write it off as the alcohol; get it checked.
Is abobotulinumtoxinA safe during pregnancy or breastfeeding?
There are no adequate data on abobotulinumtoxinA use in pregnant women to establish a drug-related risk, and it is not known whether the toxin is present in human milk or what effect it might have on a nursing infant. Because of that, the label leaves the decision to you and your doctor after weighing the benefit against the unknowns. Cosmetic treatment for frown lines is elective and is usually postponed until after pregnancy and breastfeeding. For cervical dystonia or spasticity, the discussion is different, since untreated symptoms carry their own problems. Tell your injector if you are pregnant, trying to conceive, or nursing before the appointment.
Do I need to avoid food or certain activities around the injection?
There are no food or drink restrictions, since the medicine is injected into muscle rather than swallowed. After glabellar line injections, injectors commonly ask you to stay upright for about 4 hours and avoid rubbing or massaging the treated area so the medicine stays where it was placed. Skip heavy exercise, saunas, and facials the same day. If you were injected in the neck for cervical dystonia, eat slowly and take small bites in the first weeks, because swallowing can be temporarily weaker. Stop eating and call your doctor if food or liquid makes you cough or choke.
What are the signs of too much abobotulinumtoxinA?
An excessive dose does not usually cause symptoms right away. Over the following days to weeks, look for muscle weakness that spreads beyond the injected area, trouble holding your head up, drooping eyelids, double or blurred vision, slurred or breathy speech, difficulty swallowing, constipation, loss of bladder control, and shortness of breath. Any of these needs urgent medical evaluation, and breathing trouble or collapse means calling 911. If an overdose or accidental exposure is suspected, call Poison Control at 1-800-222-1222; monitoring may be needed for several weeks because symptoms can be delayed.
What medicines interact with abobotulinumtoxinA?
Aminoglycoside antibiotics such as gentamicin, tobramycin, and amikacin can amplify the toxin effect and cause more muscle weakness. The same applies to curare-like neuromuscular blocking agents used in surgery and to muscle relaxants. Anticholinergic medicines can add to dry mouth and other effects. Getting another botulinum toxin product within the last 3 to 4 months stacks the doses, so tell your injector about every prior treatment including cosmetic ones. Blood thinners and aspirin do not block the drug but increase bruising at the injection site. Bring a full medication list, including supplements, to each appointment.