Maximizing extraction of botulinum toxin type A from vials.

Abstract

To determine the residual botulinum toxin remaining in vials after using 3 different extraction methods and to analyze the different techniques for measuring extraction efficacy. Multicentered comparative study. Three academic movement disorder clinics. Thirty physicians were randomly surveyed for their botulinum toxin extraction methods. Three physicians evaluated the most common methods. Not applicable. Amount of toxin left in vials after each extraction method. Toxin was least successfully extracted by using the vial inversion method. More toxin was extracted by using the 2-in needle method. The top removal method produced the least waste of toxin but is considered unsafe. The best and safest method for consistently extracting the most botulinum toxin from its vial was to use a long 21-gauge 2-in needle attached to a 3-mL syringe.