Can You Get Shingrix With Botox?

There is no interaction between the two.

Dec 03, 2018

KATHY asked

If a person gets the Shingrix vaccine, how long should they wait before getting Botox?

At a glance

  • There is no known drug interaction between Shingrix and Botox. They both are associated with causing 'flu-like symptoms' however in a small number of individuals.


There is no contraindication or known interaction between Shingrix, the shingles vaccine, and Botox. Additionally, Botox is not thought to alter or affect an immune response to vaccines.

Therefore, based on available data, there is no advised 'waiting period' between a Botox injection and getting Shingrix.

Having said that, both carry the risk of mild to moderate 'flu-like' symptoms after administration. These symptoms include:

  • Fever
  • Chills
  • Headache
  • Cough
  • Congestion
  • Fatigue

So, there theoretically is a chance that some side effects may be potentiated if given at the same time or in the same day.

If you have never been administered a vaccine and Botox around the same time, it may be prudent to only get one and assess whether or not you experience side effects.

Both also have the risk of causing injection site tenderness, but they most often are not administered in the same area (Botox being more common in the face while Shingrix is given in the deltoid area).

The prescribing information for Botox does not list any sort of interaction with any vaccine. In fact, it states only two known drug interactions:

Co-administration of BOTOX and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX may potentiate systemic anticholinergic effects.

There have been a few studies that looked into whether or not Botox and tetanus antibodies interact with each other, but most results point to any interaction being insignificant.

In regard to Botox interacting with aminoglycosides, they are a class of antibiotics. The effects of Botox can be potentiated by systemic aminoglycosides. Aminoglycoside drugs include:

  • Amikacin
  • Gentamicin
  • Kanamycin
  • Neomycin
  • Streptomycin
  • Tobramycin

Aminoglycosides are in no way related to the Shingrix.

As everyone's medical situation is unique, be sure to discuss whether or not they recommend for you to get Botox and Shingrix near or at the same time. They both have other considerations to take into account and your doctor will be your best resource.

About Shingrix

Shingrix is a vaccine used to prevent shingles in adults 50 years old and over. It does not treat active infections or nerve pain from shingles.

It is a non-live, recombinant vaccine, recommended by the Centers for Disease Control for all adults 50 years of age and older and without a contraindication (e.g. an allergy).

It is also recommended for those that have previously been administered Zostavax, as data suggests it is more effective for longer periods of time.

Shingrix is given as a two-shot series, with doses separated by 2 to 6 months.

About Botox

Botox (OnabotulinumtoxinA) is an intramuscular toxin (neuro-muscular blocker) produced from the fermentation of Clostridium botulinum bacteria,

In addition to its known cosmetic applications (commonly used to reduce the appearance frown lines, crow’s feet lines, forehead lines etc...), it is also indicated for the treatment of:

  • Blepharospasm (eye lid spasm)
  • Urinary incontinence due to neurologic conditions
  • Excessive sweating
  • Migraines
  • Muscle spasticity

While generally well tolerated, it is important to seek medical attention if you experience any of the following side effects:

  • Allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • Breathing problems
  • Changes in vision
  • Chest pain or tightness
  • Eye irritation
  • Irregular heartbeat
  • Speech problems
  • Swallowing problems
  • Unusual weakness
  1. Cross reaction of tetanus and botulinum neurotoxins A and B and the boosting effect of botulinum neurotoxins A and B on a primary anti-tetanus antibody response. PubMed
  2. Potentiation of Clostridium botulinum toxin aminoglycoside antibiotics: clinical and laboratory observations. PubMed
  3. Shingrix Prescribing Information. GSKPro

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