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Botox or Dysport which is better

One needs to look at the literature on Dysport today and compare it with the literature from Europe 10 years ago. Suddenly they want one to believe Dysport and Botox act in an identical manner. Why do earlier and current studies show that Dysport acts more quicly than
Botox? It is a scientific fact that smaller molecules diffuse further than larger molecules (spread from the point of Injection.) and Dysport is a smaller molecule than Botox. This is why injecting the frown with Dysport usually will affect most of the forehead area above the frown. I shared over 35 articles with Medicis(distributor of Dyport in the USA)about
this, but they just don't want or care to
understand the truth. Their theory, espoused by Dr Monheit for Medicis is that
when toxins, including Dysport, are
injected into the body they suddenly reach the pH environment of the body and they loose their protein envelope releasing the pure botulinum molecule. And this is why all type A
toxins diffuse equally. However Dr Monheit* obviously does not realize that Dysport and Botox are both stored at the same pH as the body and there is no pH change upon injection. Well, there goes Monheit's* theory; yet Medicis and much of the derm literature still supports Moneheit?s ridiculous

theory to this day. There was recently an article on(Neurol Sci. 2011 Jun 28. )that was a
?Retrospective evaluation of the dose equivalence of Botox(®) and Dysport (®)? in the management of blepharospasm and hemifacial spasm: a novel paradigm for a never
ending story.? As the authors stated Botox(®) and Dysport(®) are the preparations of botulinum neurotoxin most widely used for
therapeutic and cosmetic purposes. Several studies have addressed the topic of the equivalency ratio (D/B ratio) to be used in clinical practice. Whether a reliable value exists is a matter of debate and unlikely. To this purpose, the authors retrospectively
examinined patients affected by hemifacial spasm and blepharospasm. They compared the pairs of treatments with a switch from one brand to the other undergone by the same patient in consecutive sessions with overlapping clinical outcome. Out of 2006 treatments, they found 51 treatment pairs. D/B ratio was extremely variable (range 1.2-13.3) and in most cases (65%) it was between 1:3 and 1:5. In conclusion, even if the 1:4 ratio might be reliable for clinical purpose, a true bioequivalence between Dysport(®) and Botox(®) might not exist due to the intrinsic pharmacokinetic properties differences between Botox andDysport. Furthermore, as stated in the insert, the potency
Units of Dysport are not interchangeable with other preparations of botulinum toxin
products and, therefore, units of biological activity of Dysport cannot be compared to or converted into Units of any other botulinum toxin products. Recommended dose and frequency of administration should not be exceeded. In regards to the crows-feet study one must remember it was sponsored by Medicis who distributes Dysport so the results cannot considered to be objective and furthermore this is an unapproved indication. Why the FDA allowed Medicis to promote the results of this off-label study is a question Peggy Hamburg at the FDA needs to answerEdit

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Doctor/Professional Answers (2)   


Plastic surgeon
Miami, FL
United States
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November 15, 2011 6:21 AM

In my practice I use BOTOX in a 4 cc dilution to 100 units. I use Dysport in a 2.5:1 units to Botox in a 6.75 cc dilution to 300 cc's. This can vary but this seems to work for me in a true (more)
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Plastic surgeon
englewood cliffs, NJ
United States
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November 14, 2011 12:43 PM

coke v. pepsi (more)
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