Botox Brands: Complete Comparative Guide

Botulinum toxin brands: comparative guide

Not all botulinum toxin brands are created equal. Although the term "Botox" is used colloquially for any injectable neuromodulator, there are six FDA-approved brands, each with a distinct molecular formulation, a different diffusion profile, and its own clinical characteristics. Choosing between them is not a matter of which is "better," but rather which best suits the patient's anatomy, treatment goal, and medical history.

If you're looking to understand how botulinum toxin works at the molecular level—its mechanism of action on the neuromuscular junction—that information is in our guide to what is Botox. This article focuses exclusively on comparing brands: what differentiates them, how they are dosed, and when one is preferable to another.

Summary

• There are six FDA-approved botulinum toxin brands: Botox (Allergan/AbbVie), Dysport (Galderma/Ipsen), Xeomin (Merz), Daxxify (Revance), Jeuveau (Evolus), and Myobloc (Supernus). The first five are type A; Myobloc is type B.
• Units are NOT interchangeable between brands: 1 unit of Botox equals 2.5–3 units of Dysport. Confusing doses can cause adverse effects or insufficient results.
• Trade names change by region: Botox is called Vistabel in Europe (cosmetic use), Dysport is called Azzalure, and Xeomin is called Bocouture. The molecule is the same.
• Daxxify is the first long-acting toxin: with a median 6-month duration (up to 9 in some patients), it uses a stabilizing peptide instead of human albumin.
• Brand selection should be based on the area being treated, the diffusion profile needed, the patient's immunological history, and the physician's experience with each product.

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The six FDA-approved brands

The FDA has approved six injectable botulinum toxins, each with a unique nonproprietary name. In 2009, the FDA assigned distinct generic names (onabotulinumtoxinA, abobotulinumtoxinA, etc.) specifically to prevent dosing confusion between products that are not bioequivalent.

Botox — OnabotulinumtoxinA (Allergan/AbbVie)

Botox was the first botulinum toxin approved by the FDA in 1989. It is the neuromodulator with the most published clinical evidence and the reference standard for comparative studies. Its 900 kDa protein complex includes complexing proteins and active neurotoxin of 150 kDa, stabilized with human serum albumin and sodium chloride. It requires refrigeration. Available in vials of 50, 100, and 200 units. Typical onset is 3 to 5 days, with duration of 3 to 4 months. Its approved indications range from glabellar lines and crow's feet to chronic migraine, spasticity, hyperhidrosis, and overactive bladder.

The current Botox formulation contains less inactive protein than the original formulation, which reduced the rate of neutralizing antibody formation. Nevertheless, clinical data from Allergan report an antibody rate of approximately 1.5% in long-term treated patients.

Dysport — AbobotulinumtoxinA (Galderma/Ipsen)

Dysport received FDA approval in 2009 for glabellar lines and cervical dystonia. Its protein complex is approximately 500 kDa, smaller than Botox, and is stabilized with human serum albumin and lactose. It also requires refrigeration. Available in vials of 300 and 500 units.

The most clinically relevant difference with Dysport is its greater diffusion from the injection point. This makes it particularly useful in large areas such as the forehead, where a more homogeneous effect is desired. Its onset is typically slightly faster (2 to 3 days), and duration is comparable to Botox (3 to 4 months). The conversion ratio with Botox is 2.5:1 to 3:1 (for each unit of Botox, 2.5 to 3 units of Dysport are used), according to clinical studies published in Movement Disorders.

Xeomin — IncobotulinumtoxinA (Merz)

Xeomin is the only botulinum toxin containing exclusively the active 150 kDa neurotoxin, without complexing proteins. It was approved by the FDA in 2010. It is stabilized with human serum albumin and sucrose. Its main differentiator: it does not require refrigeration and can be stored at room temperature throughout its shelf life.

The absence of complexing proteins has two clinical implications. First: lower total protein load injected, which theoretically reduces the risk of neutralizing antibody formation. A study published in the Journal of Neurology found an antibody incidence of only 0.37% annually in patients treated exclusively with Xeomin. Second: room temperature stability simplifies the cold chain, which for the patient is an indirect signal that the product maintains its potency without relying on perfect refrigeration management during distribution and storage.

The dose equivalency with Botox is 1:1 in most clinical studies. Onset is 3 to 4 days and duration is 3 to 4 months.

Daxxify — DaxibotulinumtoxinA-lanm (Revance)

Daxxify is the most recent addition to the type A toxin market, approved by the FDA in September 2022 for glabellar lines. Its main innovation is duration: median efficacy is 6 months, with results extending up to 9 months in some patients, according to data published in PubMed.

Daxxify's formulation uses a proprietary stabilizing peptide (RTP004) instead of human serum albumin, making it the first botulinum toxin without human blood-derived components. It contains the active 150 kDa neurotoxin (without complexing proteins), similar to Xeomin in that regard. It requires refrigeration. Available in 100-unit vials.

Daxxify is not yet approved in the European Union or most Latin American markets. Its onset is the fastest in the group (1 to 2 days).

Jeuveau — PrabotulinumtoxinA (Evolus)

Jeuveau was approved by the FDA in February 2019 and is the only botulinum toxin in the U.S. market approved exclusively for aesthetic use (glabellar lines). It has no therapeutic indications. It is manufactured by Daewoong Pharmaceutical (South Korea) and commercialized in the U.S. by Evolus.

Its protein complex is 900 kDa, similar to Botox. It uses Hi-Pure technology, which achieves a purity of at least 95% according to Evolus, and is vacuum-dried rather than lyophilized, which prevents crystal formation. It is stabilized with human serum albumin and sodium chloride. It requires refrigeration. Available in 100-unit vials.

Onset is 2 to 3 days—approximately 50% of patients show improvement within 48 hours—and duration is 3 to 4 months. Equivalency with Botox is approximately 1:1, although some physicians use a ratio of 10:7 (Botox:Jeuveau).

Outside the U.S., the same molecule is commercialized as Nabota (South Korea), Nuceiva (Canada), and Alluzience (Europe).

Myobloc — RimabotulinumtoxinB (Supernus)

Myobloc is the only FDA-approved type B botulinum toxin. Its approval dates to December 2000, originally for cervical dystonia, with a subsequent indication for chronic sialorrea according to Myobloc prescribing information. It does not have approval for cosmetic use.

Unlike all type A toxins, Myobloc comes as a ready-to-use liquid solution (requires no reconstitution) in vials of 2,500, 5,000, and 10,000 units. Its units are not comparable to those of any type A toxin. The complex is approximately 700 kDa.

Myobloc has specific clinical relevance: it can be effective in patients who have developed resistance (neutralizing antibodies) to type A toxin, since it acts on a different protein (VAMP instead of SNAP-25). It is included in this guide for completeness, but it is not a standard cosmetic product.

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Comparative table of 6 brands

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Trade names by region

The same active ingredients are marketed under different names depending on the country and type of indication (cosmetic vs. therapeutic). This frequently causes confusion, especially for patients who travel or research online.

In Spain, if your doctor uses "Vistabel," it is the same onabotulinumtoxinA that is called Botox Cosmetic in the United States or simply Botox in Mexico. If they use "Azzalure," it is Dysport. If they use "Bocouture," it is Xeomin. The active molecule is identical in each case.

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Unit equivalency between brands

Units of Botox and Dysport are NOT interchangeable: 1 unit of Botox equals approximately 2.5 to 3 units of Dysport. This is not a minor difference—confusing dosing can result in excessive paralysis or insufficient treatment.

Clinical conversion ratios, based on published studies, are:

• Botox : Dysport = 1 : 2.5–3. A randomized double-blind study in Movement Disorders confirmed the non-inferiority of Dysport versus Botox at a 2.5:1 ratio in cervical dystonia. In clinical practice, most physicians use between 2.5:1 and 3:1 depending on the area.
• Botox : Xeomin = 1 : 1. Most clinical studies demonstrate direct equivalency.
• Botox : Jeuveau ≈ 1 : 1. Some professionals report using a ratio of 10:7 (Botox:Jeuveau), but 1:1 equivalency is the most accepted.
• Botox : Daxxify: There is no official published conversion ratio. Daxxify is dosed according to its own scheme (40 units for glabella).
• Myobloc (type B): Its units are not comparable to any type A toxin. Therapeutic doses of Myobloc are on the order of 2,500 to 10,000 units, reflecting a completely different scale.

The FDA required in 2009 that each brand adopt a unique nonproprietary name (onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, etc.) specifically to prevent dosing errors. When your doctor tells you how many units they will use, always ask which brand it is.

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What is the best botulinum toxin brand?

There is no universally superior brand: the choice depends on the anatomical area, the clinical goal, and the patient profile. That said, there are scenarios where one brand has an advantage over the others. Here is a practical decision framework:

Botox is the preferred option when precision and result predictability are needed. With a more contained diffusion profile than Dysport, it is especially useful in periorbital areas (crow's feet, glabella) where product migration can cause eyelid ptosis. It is also the toxin with the most support from evidence in therapeutic indications such as chronic migraine and hyperhidrosis.

Dysport is advantageous in large areas where homogeneous coverage is desired, such as the forehead. Its greater diffusion from the injection point allows treating extensive areas with fewer injection points, and its slightly faster onset (2–3 days vs. 3–5 for Botox) can be relevant for patients with upcoming events. Some physicians also report a more "natural" and less "frozen" appearance on the forehead with Dysport, although this depends largely on injection technique.

Xeomin is the logical choice for patients with history of loss of response (resistance) to other toxins or concern about immunogenicity. Its formulation without complexing proteins presents the lowest total protein load, with a neutralizing antibody incidence of 0.37% annually according to published data. It is also a practical option in contexts where the cold chain is difficult to guarantee, since it requires no refrigeration.

Daxxify is the only current option for patients seeking prolonged duration without frequent reapplications. With a median 6-month duration, it can reduce annual visits from 3–4 to just 2. Its onset is the fastest (1–2 days). It is a good option for patients with demanding schedules or who travel frequently. Limitation: it is currently only approved for glabellar lines and availability outside the U.S. is limited.

Jeuveau is a competitive alternative for patients focused exclusively on aesthetics seeking results equivalent to Botox. Its onset is fast (2–3 days) and its efficacy profile is comparable. In some markets, it has more accessible price positioning.

Myobloc occupies a specific therapeutic niche: patients with cervical dystonia or sialorrea who do not respond to type A toxins, or who have developed neutralizing antibodies against the type A serotype.

In clinical practice

At Juvenalia Brío, we work with Botox (Allergan) and Dysport (Galderma), selecting based on anatomy: Botox for areas requiring precision (periocular, glabella), Dysport for large areas (forehead). Both are original products with FDA and COFEPRIS approval, stored in continuous cold chain.

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FDA-unapproved brands

Search data show that many patients research brands that do not have FDA approval. It is important to be aware of them and understand their regulatory status.

Linurase

Linurase is a Chinese-origin botulinum toxin brand, associated with the laboratory Phiderma (Canada) for distribution. It does not have FDA, EMA, or COFEPRIS approval. Although it circulates in some markets, the FDA has documented risks associated with botulinum toxins from unverified sources, including hospitalizations for systemic dissemination symptoms. It should not be confused with approved brands.

Innotox (Medytox)

Innotox is the first liquid ready-to-use type A botulinum toxin, manufactured by Medytox (South Korea). It has been approved by the South Korean MFDS since 2013, but has no FDA approval. Its liquid format eliminates the need for reconstitution, but this also means that providers cannot adjust dilution—a tool that experienced physicians consider important for personalizing treatment.

Innotox has generated media concern over its unregulated online sale and use in self-injection, a practice with serious documented risks including unwanted muscle paralysis, ptosis, and breathing difficulty.

Nabota (Daewoong)

Nabota is the same molecule as Jeuveau (prabotulinumtoxinA). In the U.S., it is legally marketed as Jeuveau through Evolus. Outside the U.S. regulatory system, the same molecule is sold as Nabota in South Korea and other Asian markets. If you find "Nabota" for sale outside these channels, sourcing and storage cannot be verified.

Other circulating names

Products such as Neuronox (Medytox), Meditoxin (Medytox), Relatox (Russia), Lantox/Prosigne (China), and Hutox (Huons, South Korea) are botulinum toxins approved in their home markets but without FDA, EMA, or COFEPRIS approval. Potency, purity, and manufacturing standards may differ significantly from internationally approved brands.

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Regulation by agency: FDA, COFEPRIS, EMA, ANVISA, INVIMA

Regulatory approval is not uniform across countries, and each brand's availability varies by market.

• FDA (United States): Approves the six brands described in this article. Requires unique nonproprietary names since 2009.
• COFEPRIS (Mexico): Approves Botox, Dysport, and Xeomin. Daxxify and Jeuveau are not available at the time of this publication. All botulinum toxin products must have current COFEPRIS registration to be legally used in Mexico.
• EMA / AEMPS (European Union / Spain): Approves Botox/Vistabel, Dysport/Azzalure, Xeomin/Bocouture, and Alluzience (Jeuveau). Daxxify does not have European approval.
• ANVISA (Brazil): Approves Botox, Dysport, and Xeomin. Brazil is one of the largest aesthetic markets in Latin America.
• INVIMA (Colombia): Approves Botox, Dysport, and Xeomin. Strict regulation on imported products.

A product approved by the FDA but not by COFEPRIS cannot be legally used in Mexico, and vice versa. Always confirm with your doctor that the product being used has current regulatory registration in your country.

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How to verify product authenticity

The existence of counterfeit botulinum toxins is a documented problem. The FDA issued an alert in 2024 about counterfeit versions of Botox found in multiple U.S. states, with hospitalizations reported for toxin dissemination symptoms.

Key points to verify authenticity:

• Active ingredient name: The packaging must state the exact nonproprietary name (e.g., "OnabotulinumtoxinA" for Botox, not generically "Botulinum Toxin Type A"). The FDA identifies this error as a sign of counterfeiting.
• Hologram and lot code: Botox (Allergan/AbbVie) includes security holograms on the packaging. Verify that they are present and intact.
• Cold chain: All neuromodulators except Xeomin require continuous refrigeration (2–8 °C). If an office does not have a visible medication refrigerator, ask about storage.
• Reconstitution before patient: It is good practice for the physician to prepare the product (reconstitution of lyophilized powder with saline solution) in the patient's presence or have the patient see the sealed vial before use.
• Regulatory registration: In Mexico, verify COFEPRIS registration. In Spain, AEMPS registration. In Brazil, ANVISA. In Colombia, INVIMA.

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Resistance and antibody formation

All botulinum toxin neuromodulators can induce the formation of neutralizing antibodies that reduce or eliminate their effect with repeated use. It is an infrequent but clinically relevant phenomenon.

Specific data by brand:

• Botox: The current formulation (post-1997, with lower protein load) presents an antibody rate of approximately 1.5% according to Allergan clinical data. The original formulation had a significantly higher rate.
• Xeomin: The lowest documented incidence: 0.37% annually in patients treated exclusively with Xeomin, according to a long-term study in the Journal of Neurology. A study published in Biologics: Targets and Therapy confirms that the absence of complexing proteins reduces immunogenicity in animal models and preliminary human data.
• Dysport, Jeuveau, Daxxify: Specific antibody data are more limited in the literature, but the same principles apply: higher total protein load = higher theoretical risk.

When a patient notices that the effect of their botulinum toxin has diminished or stopped working after multiple cycles, the usual strategy is to switch to a brand with lower protein load (Xeomin) or, in extreme cases, to a type B toxin (Myobloc). Factors that increase antibody risk include high doses, short intervals between sessions, and total amount of injected protein.

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Frequently asked questions

What are the botox brands?

There are six FDA-approved botulinum toxin brands: Botox (Allergan/AbbVie), Dysport (Galderma/Ipsen), Xeomin (Merz), Daxxify (Revance), Jeuveau (Evolus), and Myobloc (Supernus). The first five contain type A botulinum toxin, while Myobloc is type B. Each has a distinct molecular formulation, a unique generic name, and non-interchangeable units. Outside the U.S., these same molecules are marketed under different names: Vistabel, Azzalure, Bocouture, Alluzience, and NeuroBloc, among others. In Mexico, brands with current COFEPRIS registration include Botox, Dysport, and Xeomin.

What is the best botox brand?

There is no universally superior brand; the best option depends on the anatomical area and clinical goal. Botox offers the most contained diffusion profile, ideal for periocular areas where precision is needed. Dysport has greater diffusion and faster onset, advantageous for the forehead and large areas. Xeomin is the preferred option for patients concerned about antibody formation or with a history of resistance, thanks to its formulation without complexing proteins. Daxxify stands out for its up to 6-month duration. The decision is made by the physician evaluating anatomy, history, and goals for each patient.

What are the best botox brands?

The brands with the most clinical evidence and track record are Botox (since 1989), Dysport (since 2009), and Xeomin (since 2010). These three have approval in most international markets, including FDA, EMA, and COFEPRIS. Daxxify (2022) is the most innovative for its prolonged duration, and Jeuveau (2019) offers a competitive aesthetic-only alternative. The "best" depends on context: for maximum published evidence, Botox; for lowest immunogenicity, Xeomin; for longest duration, Daxxify; for large areas, Dysport.

What is the best botox for the face?

For cosmetic facial use, Botox, Dysport, Xeomin, Daxxify, and Jeuveau are all valid options with demonstrated efficacy in clinical studies. Selection depends on the specific area: Botox is frequently preferred for glabella and periocular area for its controlled diffusion; Dysport for full forehead for its broader distribution. Xeomin offers a profile similar to Botox with the advantage of lower immunological risk. Daxxify is the choice when duration is prioritized (6+ months). What matters most is not the brand but the experience of the injecting physician and injection technique.

What are the types of botox?

There are two types of botulinum toxin approved for clinical use: type A and type B. Type A toxin includes five brands (Botox, Dysport, Xeomin, Daxxify, and Jeuveau), and is used in the vast majority of aesthetic treatments. Type B toxin (Myobloc/NeuroBloc) is approved for therapeutic indications such as cervical dystonia and sialorrea, not for conventional cosmetic use. Within type A, brands differ in molecular complex size, stabilizer, diffusion profile, and duration. They are not interchangeable in dosing or exact indications.

What are the botulinum toxin brands?

The six FDA-approved brands are: OnabotulinumtoxinA (Botox, by Allergan/AbbVie), AbobotulinumtoxinA (Dysport, by Galderma/Ipsen), IncobotulinumtoxinA (Xeomin, by Merz), DaxibotulinumtoxinA-lanm (Daxxify, by Revance), PrabotulinumtoxinA (Jeuveau, by Evolus), and RimabotulinumtoxinB (Myobloc, by Supernus). Each generic name is unique because the formulations are not bioequivalent. Outside the U.S., there are other brands such as Nabota, Innotox, Neuronox, Relatox, and Lantox, but these do not have FDA approval and, in many cases, do not have approval from other major international regulatory agencies.

What is the best botulinum toxin?

The botulinum toxin with the most scientific support is onabotulinumtoxinA (Botox), with over 35 years on the market and the largest number of published clinical studies. However, "best" depends on the criterion: for lowest immunogenicity, incobotulinumtoxinA (Xeomin) has the lowest documented antibody rate (0.37% annually). For longest duration, daxibotulinumtoxinA (Daxxify) offers 6 months median. For broad diffusion and fast onset, abobotulinumtoxinA (Dysport) has advantages. None is objectively "the best" for all patients; the optimal selection is the one made by an experienced physician based on individual anatomy and goals.

Which botox brand is better?

The optimal brand varies by clinical scenario. If you need precision in small areas (glabella, crow's feet), Botox has the most predictable diffusion profile. If treating a large area like the forehead, Dysport offers more homogeneous coverage with fewer injection points. If you have a history of prolonged toxin use and concern about resistance, Xeomin minimizes exposure to complexing proteins. If you seek results lasting twice as long, Daxxify is the only option with demonstrated 6+ month duration. Brand matters less than physician experience and product quality (authenticity, proper storage).

What are the facial botox brands?

The botulinum toxin brands approved for cosmetic facial use are Botox Cosmetic (Allergan), Dysport (Galderma), Xeomin (Merz), Daxxify (Revance), and Jeuveau (Evolus). All are FDA-approved at least for glabellar lines (frown lines). Botox Cosmetic also has approval for crow's feet and forehead lines. Dysport has approval for glabella. Other facial indications (forehead, chin, platysmal bands) are frequently used off-label with all brands. Myobloc (type B) is not used for cosmetic facial indications. In Europe, the cosmetic equivalent names are Vistabel, Azzalure, Bocouture, and Alluzience.

What is the difference between Botox and Dysport?

Botox and Dysport contain different molecules (onabotulinumtoxinA vs. abobotulinumtoxinA) with real clinical differences. Dysport has a smaller molecular complex (~500 kDa vs. 900 kDa), which contributes to its greater diffusion from the injection point. Its units are not equivalent: 2.5 to 3 units of Dysport are needed for each unit of Botox. Dysport tends to have faster onset (2–3 days vs. 3–5) and broader tissue distribution, making it preferable for large areas. Duration is similar (3–4 months). Both require refrigeration and use human serum albumin as stabilizer, although Dysport uses lactose instead of sodium chloride.

Is Xeomin brand good?

Xeomin (incobotulinumtoxinA, Merz) is a brand with extensive clinical support, FDA-approved since 2010 and available in over 70 countries. Its distinctive feature is the absence of complexing proteins: it contains only the active 150 kDa neurotoxin. This gives it the lowest documented antibody formation rate among type A toxins, with an incidence of only 0.37% annually according to a long-term study. Its efficacy is clinically equivalent to Botox in a 1:1 ratio. Additionally, it is the only botulinum toxin that does not require refrigeration, which simplifies storage logistics. It is a particularly valid option for patients with prolonged toxin use or concern about resistance.

What are the botulinum toxin brands approved by the FDA?

The six FDA-approved brands are Botox (1989), Myobloc (2000), Dysport (2009), Xeomin (2010), Jeuveau (2019), and Daxxify (2022). Five are type A toxin and one (Myobloc) is type B. Each brand has a unique generic name assigned by the FDA to prevent dosing errors, as units are not interchangeable between products. FDA approval is specific to each indication: Botox has the most approved indications (cosmetic and therapeutic), while Jeuveau is only approved for glabellar lines for aesthetic purposes. It is important to verify that FDA approval is complemented by approval from your country's regulatory agency (COFEPRIS in Mexico, AEMPS in Spain, ANVISA in Brazil).