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Pyridostigimine to reverse botox?

Injectables

Anonymous

July 27th, 2025 10:21

Patient description

Dear all,

I received a report that pyridostigmine sometimes is used to antagonize undesired effect of botox on facial muscles (frozen face).

Pyridostigmine is a medication which can have serious side effects, it needs close monitoring and I don’t use it.

It did not find pyridostigmine in guidelines for treatment of botulinum toxin induced brow ptosis, nor eyelid ptosis.

I found literature about it is use for treatment of botulism and for example treatment of swallowing difficulties and hoarseness caused by botulinum toxin used for dystonia.

Searching for pyridostigmine on Imcas platform showed only one video with case reports, saying it shortens recovery time of eyelid ptosis.

Does anyone use of pyridostigmine to antagonize facial botox ?

Kind regards

Case description

Dear all,

I received a report that pyridostigmine sometimes is used to antagonize undesired effect of botox on facial muscles (frozen face).

Pyridostigmine is a medication which can have serious side effects, it needs close monitoring and I don’t use it.

It did not find pyridostigmine in guidelines for treatment of botulinum toxin induced brow ptosis, nor eyelid ptosis.

I found literature about it is use for treatment of botulism and for example treatment of swallowing difficulties and hoarseness caused by botulinum toxin used for dystonia.

Searching for pyridostigmine on Imcas platform showed only one video with case reports, saying it shortens recovery time of eyelid ptosis.

Does anyone use of pyridostigmine to antagonize facial botox ?

Kind regards

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Dr. Juliah TBARANI O SHEA

Cosmetic Surgeon, Ireland

July 27th, 2025 19:53

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Dr. Tzachi SHELKOVITZ

Dermatologist, Israel

July 27th, 2025 18:27

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Dr. Robyn D SIPERSTEIN

Dermatologist, United States

July 27th, 2025 17:37

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Dr. Roberta D EMILIO

MD, Italy

July 27th, 2025 12:10

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Anonymous

July 27th, 2025 11:34

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Dr. Fadi HAMADANI

Plastic Surgeon, Palestine

July 27th, 2025 10:50

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Pyridostigimine to reverse botox?

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