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Pyridostigimine to reverse botox?

Injectables

Anonymous

juillet 27, 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

Chirurgien, Irlande

juillet 27, 2025 19:53

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Dr Tzachi SHELKOVITZ

Dermatologue, Israël

juillet 27, 2025 18:27

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Dr Robyn D SIPERSTEIN

Dermatologue, États-Unis

juillet 27, 2025 17:37

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Dr Roberta D EMILIO

Médecin, Italie

juillet 27, 2025 12:10

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Anonymous

juillet 27, 2025 11:34

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Dr Fadi HAMADANI

Chirurgien Plasticien, Territoire palestinien

juillet 27, 2025 10:50

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Pyridostigimine to reverse botox?

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