Lidocaine and OnabotulinumtoxinA interaction

Lidocaine and OnabotulinumtoxinA: the OnabotulinumtoxinA prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the OnabotulinumtoxinA (BOTOX) label · effective 2026-02-02

Major

One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent, and consequently the causal agent cannot be reliably determined.

Warnings and precautionsnames LidocaineView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.