Botox brands are among the most frequently asked-about topics in aesthetic medicine today. While the word "Botox" is often used as a generic term for all botulinum toxin type A products, Botox is in fact a registered trade name belonging exclusively to Allergan Aesthetics (AbbVie). As of 2026, there are more than 10 different botulinum toxin type A brands approved by the FDA, EMA and local authorities worldwide. Each has a different molecular structure, formulation, duration of action, dose equivalency and approved indications.
In this comprehensive guide we compare all the major botulinum toxin brands — including Botox, Dysport, Xeomin, Bocouture, Azzalure, Jeuveau (Nuceiva), Daxxify, Letybo, Relfydess, Neuronox (Meditoxin) and Innotox — in the light of evidence-based medical literature. We cover dose equivalencies, onset and duration of action, storage conditions and how to identify an original product, step by step. Please contact us for current pricing information.
What Is Botulinum Toxin and Why Are There Different Brands?
Botulinum toxin is produced by the bacterium Clostridium botulinum and is one of the most potent biological neurotoxins known. In medical use, only type A (and rarely type B) is purified and prepared at therapeutic doses. The active toxin molecule weighs approximately 150 kDa and consists of two chains (heavy and light). During production, various accessory complex proteins (haemagglutinins and non-haemagglutinin proteins) are added around this 150 kDa active molecule to create final products of different sizes (300, 500 and 900 kDa).
The key differences between brands stem from three main points: (1) the production bacterial strain, (2) the purification and stabiliser system, and (3) the complex protein content. These differences determine the unit size, the degree of diffusion, the onset time, the antigenicity risk and storage conditions. This means that 1 unit of Botox does not equal 1 unit of Dysport; each brand has its own unit system and dosing must be calculated according to these equivalency tables.
Technical Parameters that Differentiate Botulinum Toxin Brands
- Generic (INN) name: Each brand has an international non-proprietary name assigned by the World Health Organisation (onabotulinumtoxinA, abobotulinumtoxinA, etc.).
- Molecular weight: Ranges from 150 kDa (pure) to 900 kDa (full complex). Lower molecular weight may theoretically mean lower antigenic potential.
- Accessory protein content: Xeomin/Bocouture contain no accessory proteins, whereas Botox and Dysport do.
- Stabiliser: Most brands use human serum albumin; Daxxify uses a peptide-based stabiliser (RTP004).
- Onset of action: Dysport onset is 1–2 days, Jeuveau 2–3 days, Botox/Xeomin 3–5 days.
- Duration of action: Standard brands last 3–4 months; Daxxify can be effective for up to 6 months.
- Storage: Xeomin can be stored at room temperature; other brands require refrigeration at 2–8°C.
Botox Brands — Full List (2026)
The table below summarises the leading botulinum toxin type A brands licensed and in clinical use worldwide as of 2026. The three main brands in routine use at licensed clinics are Botox, Dysport and Xeomin. Other brands are used in specific countries or for selected indications.
| Brand | Generic Name | Manufacturer | Approval | Molecular Weight | Storage |
|---|---|---|---|---|---|
| Botox | OnabotulinumtoxinA | Allergan Aesthetics / AbbVie (USA) | FDA 1989, 2002 (cosmetic) | 900 kDa | 2–8°C |
| Dysport | AbobotulinumtoxinA | Ipsen (France) / Galderma | FDA 2009, EMA | 500–900 kDa | 2–8°C |
| Xeomin | IncobotulinumtoxinA | Merz Pharmaceuticals (Germany) | FDA 2010, EMA | 150 kDa (pure) | Room temp or 2–25°C |
| Bocouture | IncobotulinumtoxinA | Merz Pharmaceuticals | EMA (EU aesthetic brand) | 150 kDa (pure) | Room temp or 2–25°C |
| Azzalure | AbobotulinumtoxinA | Galderma / Ipsen | EMA (EU aesthetic brand) | 500–900 kDa | 2–8°C |
| Jeuveau (USA) / Nuceiva (EU) | PrabotulinumtoxinA-xvfs | Evolus (USA) / Daewoong (S. Korea) | FDA 2019, Health Canada | 900 kDa | 2–8°C |
| Daxxify | DaxibotulinumtoxinA-lanm | Revance Therapeutics (USA) | FDA 2022 (cosmetic), 2023 (cervical dystonia) | 150 kDa + peptide stabiliser | 2–8°C |
| Letybo | LetibotulinumtoxinA | Hugel (South Korea) | FDA 2024, EMA, KFDA | ~900 kDa | 2–8°C |
| Relfydess | RelabotulinumtoxinA | Galderma / Ipsen | EMA 2024 (EU approval), US application in progress | Liquid (ready to use) | 2–8°C |
| Neuronox / Meditoxin | ClostridiumbotulinumtoxinA | Medytox (S. Korea) | KFDA, Asian markets, select EU | 900 kDa | 2–8°C |
| Innotox | ClostridiumbotulinumtoxinA (liquid) | Medytox (S. Korea) | KFDA (South Korea, liquid form) | Liquid (ready to use) | 2–8°C |
| Myobloc / Neurobloc | RimabotulinumtoxinB (type B) | Supernus Pharmaceuticals | FDA 2000 (cervical dystonia) | Type B toxin | 2–8°C |
1. Botox (OnabotulinumtoxinA) — Allergan Aesthetics
Botox is the best-known, most extensively researched and most widely used botulinum toxin brand in the world. It was approved by the FDA in 1989 for blepharospasm and strabismus, and received cosmetic approval for glabellar lines in 2002. Manufactured by Allergan Aesthetics (part of AbbVie since 2020), the trade name Botox belongs exclusively to this product. The generic use of "Botox" to refer to all products is, much like "Aspirin", a testament to how deeply the brand has become embedded in public consciousness.
Technical Specifications of Botox
- Generic name: OnabotulinumtoxinA
- Molecular weight: 900 kDa (including accessory complex proteins)
- Formulation: Lyophilised powder; reconstituted with sterile saline before use
- Vial sizes: 50, 100 and 200 units
- Storage: At 2–8°C in original packaging; must be used within 24 hours of reconstitution
- Onset of action: 3–5 days; full effect 10–14 days
- Duration of action: Average 3–4 months (2–6 months with individual variation)
FDA-Approved Indications for Botox
Among botulinum toxin brands, Botox has the widest approved indication range. In addition to cosmetic applications, it has been approved by the FDA for dozens of medical indications including: glabellar (frown) lines, lateral canthal lines (crow's feet), forehead lines, chronic migraine, cervical dystonia, blepharospasm, hemifacial spasm, strabismus, hyperhidrosis (excessive sweating), overactive bladder, neurogenic detrusor overactivity, upper limb spasticity and paediatric spasticity. Botox has the largest body of clinical trial data and strongest evidence base of any brand.
2. Dysport (AbobotulinumtoxinA) — Ipsen / Galderma
Dysport is a botulinum toxin type A product developed by French company Ipsen and distributed in the aesthetic market by Galderma. It received European approval in 1991 and FDA approval for glabellar lines in 2009. In Europe, the same product is marketed under the name Azzalure for aesthetic indications, with identical active substance but different vial sizes and target use.
Features that Distinguish Dysport from Other Brands
- Wider spread (diffusion): Dysport tends to spread more widely from the injection point to adjacent muscle areas. This property is advantageous in large muscle areas such as the forehead, achieving homogeneous results with fewer injection points.
- Faster onset: In some patients, effects begin to be felt within as little as 1–2 days; this may be a reason for preference in patients who want rapid results.
- Different unit system: 1 unit of Botox corresponds to approximately 2.5–3 units of Dysport. For this reason, Dysport vials typically come in large 300 or 500 unit forms.
- Caution with small muscle groups: Due to its wider diffusion, greater care is needed with dosing around the eyes and fine mimetic muscles; incorrect application can increase the risk of ptosis (eyelid drooping).
Dysport has shown clinically successful results particularly in indications such as chronic migraine, hyperhidrosis, cervical dystonia and limb spasticity.
3. Xeomin (IncobotulinumtoxinA) — Merz Pharmaceuticals
Xeomin is a product manufactured by German company Merz Pharmaceuticals and marketed as "purified botulinum toxin". It received FDA approval in 2010. The most important feature distinguishing Xeomin from other brands is that it has been stripped of accessory complex proteins; it contains only pure 150 kDa neurotoxin molecules. This "naked toxin" or "bare toxin" approach is Xeomin's most distinctive characteristic.
Theoretical and Practical Advantages of Xeomin
- Low antigenic potential: The absence of accessory proteins means the risk of neutralising antibody development is theoretically lower. This is particularly important for maintaining long-term efficacy in patients receiving frequent treatments (e.g. chronic migraine, spasticity).
- Room-temperature storage: Xeomin is the only major brand that can be stored at room temperature up to 25°C. This is a significant logistical advantage, reducing cold-chain dependency for shipping and clinic operations.
- 1:1 dose equivalency: The clinical dose equivalency between Xeomin and Botox is approximately 1:1, simplifying dose calculations.
- European aesthetic brand: The same molecule is marketed in Europe as Bocouture for aesthetic indications.
Xeomin has FDA-approved indications for glabellar lines, crow's feet, forehead lines, blepharospasm, cervical dystonia, upper limb spasticity and paediatric sialorrhoea (excessive drooling).
4. Bocouture (Merz) and Azzalure (Galderma) — Europe's Aesthetic Brands
An interesting feature of the European market is that the same active substance is marketed under different trade names for medical and aesthetic indications. Bocouture is Merz's aesthetic brand, identical to Xeomin — the active substance, formulation and manufacturing process are exactly the same. Similarly, Azzalure is the brand under which Galderma presents the same product as Dysport to the aesthetic market. This dual-brand strategy was chosen to separate aesthetic marketing from the medical image and for physician segmentation.
In short: when a patient asks "which is better, Xeomin or Bocouture?" or "Dysport or Azzalure?", the answer is simple: the active substances are identical. The difference lies only in which market and for which indication they are sold.
5. Jeuveau / Nuceiva (PrabotulinumtoxinA-xvfs) — Evolus
Jeuveau is a botulinum toxin type A product launched in the US market in 2019 by Evolus Inc., with FDA approval for aesthetic treatment of glabellar lines. The active substance is manufactured by South Korean Daewoong Pharmaceutical. The same product is sold as Nuceiva in Europe, Canada and some Latin American countries. Jeuveau was positioned as a "next generation" and "purely aesthetics-focused" brand and offered as a more affordable alternative to Botox. It is sometimes referred to in marketing literature as "Newtox".
- Molecular weight: 900 kDa (similar to Botox)
- Dose equivalency: Approximately 1:1 Botox
- Onset of action: 2–3 days
- Duration of action: Average 3–5 months (EV-001 and EV-002 phase III studies, 2018)
- FDA approval: Glabellar lines only (cosmetic); no medical indications approved
6. Daxxify (DaxibotulinumtoxinA) — Revance Therapeutics
Daxxify is one of the newest-generation botulinum toxin brands, receiving FDA approval in 2022. Developed by US-based Revance Therapeutics, this product's most striking feature is that it is the first botulinum toxin to use a peptide-based stabiliser (RTP004) containing neither human serum albumin nor animal protein. Its clinical significance lies in its longest duration of action.
Features that Distinguish Daxxify from Other Brands
- Duration of action up to 6 months: In SAKURA phase III clinical studies (Revance, 2021), Daxxify's average duration of action was 6 months and up to 9 months in some patients. This is a significant advantage over standard 3–4 month brands.
- Peptide stabiliser: The proprietary peptide RTP004 provides stabilisation without using blood products, eliminating theoretical infection concerns related to blood-derived components.
- Dose equivalency: Approximately 1:1 Botox
- Approved indications: Glabellar lines (2022) and cervical dystonia (2023)
Daxxify can be a preferred option for patients who want fewer sessions per year; however, its cost is higher than standard brands. As of 2026 it is predominantly used in the US market and is not routinely licensed in all markets.
7. Letybo (LetibotulinumtoxinA) — Hugel
Letybo is a botulinum toxin type A product manufactured by South Korean Hugel Inc. It has been used in South Korea since 2010, in Europe since 2023, and received FDA approval in 2024 in the USA. It is licensed in more than 70 countries. Widely used across Asian markets, Letybo has demonstrated efficacy and safety comparable to Botox in clinical studies for glabellar lines.
- Dose equivalency: Approximately 1:1 Botox
- Onset of action: 3–5 days
- Duration of action: 3–4 months
- Pricing: Generally more affordable than Botox
8. Relfydess (RelabotulinumtoxinA) — Galderma
Relfydess, developed through a collaboration between Galderma and Ipsen, is one of the first major botulinum toxin brands in ready-to-use liquid form. It received European Medicines Agency (EMA) approval in 2024 and the US application process is ongoing. The liquid formulation aims to eliminate reconstitution errors, improving dose consistency. Relfydess shares similar diffusion characteristics with Dysport but is a purified version. Duration of action has been reported at up to 6 months in clinical studies (READY-1 and READY-2 phase III studies).
9. Neuronox / Meditoxin and Innotox — Medytox
Neuronox (marketed as Meditoxin in some markets) is produced by South Korean Medytox and is one of the most widely used botulinum toxin brands in Asia. It holds KFDA approval and is licensed in various countries. The same company's Innotox product is a ready-to-use liquid botulinum toxin product that has been available in South Korea since 2013.
Note: Medytox products have been subject to licensing and patent disputes in some countries (particularly the USA). The licensing status of these products may vary over time in different markets. Always verify the regulatory approval status of any product to be used. Use of an unlicensed product is not only illegal but also poses serious health risks.
Botox Brand Dose Equivalency Table
Unit (dose) equivalency is not the same across botulinum toxin brands. Each product uses a different unit system based on its own biological activity. The table below summarises the dose equivalency ratios most commonly used in clinical practice. These ratios are average values based on published studies; physicians should individualise them on a patient-by-patient basis.
| Brand | Equivalency vs. Botox | Equivalent to 20 U Botox | Vial Sizes |
|---|---|---|---|
| Botox | 1:1 (reference) | 20 units | 50 / 100 / 200 U |
| Xeomin / Bocouture | 1:1 | 20 units | 50 / 100 U |
| Jeuveau / Nuceiva | 1:1 | 20 units | 100 U |
| Daxxify | 1:1 | 20 units | 50 / 100 U |
| Letybo | 1:1 | 20 units | 100 / 200 U |
| Neuronox | 1:1 | 20 units | 100 / 200 U |
| Dysport / Azzalure | 1:2.5 – 1:3 | 50–60 units | 125 / 300 / 500 U |
Note: For Dysport, some physicians use a 1:2.5 equivalency ratio while others use 1:3. The physician can adjust this ratio depending on the area being treated and the individual response.
Botox Brand Onset and Duration Comparison
| Brand | Onset of Action | Full Effect | Average Duration |
|---|---|---|---|
| Dysport / Azzalure | 1–2 days | 7–10 days | 3–4 months |
| Jeuveau / Nuceiva | 2–3 days | 7–14 days | 3–5 months |
| Botox | 3–5 days | 10–14 days | 3–4 months |
| Xeomin / Bocouture | 3–5 days | 10–14 days | 3–4 months |
| Letybo | 3–5 days | 10–14 days | 3–4 months |
| Neuronox | 3–5 days | 10–14 days | 3–4 months |
| Relfydess | 2–4 days | 10–14 days | 5–6 months |
| Daxxify | 2–3 days | 10–14 days | 6 months (up to 9) |
Which Botox Brand Is Right for You?
Botox brand selection cannot be answered by asking "which brand is best?" because clinical studies demonstrate that the licensed main brands achieve similar levels of aesthetic outcome and patient satisfaction. The right question is: "Which brand best suits my treatment area, my expectations and my practitioner's experience?" Factors to consider in the selection process:
- Treatment area: For large muscle areas (forehead, neck, migraine), Dysport provides faster and wider spread; for sensitive areas (periorbital, lips), Botox or Xeomin, which remain more localised, may be preferred.
- Practitioner's experience: More predictable results are obtained with the brand the practitioner has accumulated the most experience with. Changing brands requires dose adjustment.
- Previous response: If there has been an insufficient response or suspected antibody development with previous treatments, switching to protein-free Xeomin can be considered.
- Duration of effect expectation: Standard brands suit those who are happy to repeat every 3–4 months; Daxxify is an option for those who prefer 6-monthly repetition (subject to availability).
- Budget: There are differences in brand pricing; however, the primary considerations should be the licensed status of the product and the practitioner–patient trust relationship, not the cheapest option.
- Storage conditions: In specific situations (e.g. after travel to a clinic), Xeomin's room-temperature storage advantage may be a consideration.
How to Identify Original Botox
Counterfeit or unlicensed botulinum toxin products pose a serious health risk. The content of unlicensed products is uncertain; they may not be sterile, active substance doses may be incorrect, and they can cause serious adverse events (anaphylaxis, systemic toxicity, botulism-like presentations). To verify that a Botox brand is original and licensed, follow these steps:
- Ask your physician to show you the vial: You have the right to have the product vial opened before the procedure in its original sealed packaging.
- Holographic label and lot number: Original Botox packaging has a holographic security feature and a unique lot number.
- Expiry date: Always check.
- Manufacturer information: Manufacturer logos such as Allergan, Merz and Ipsen, and relevant product information, should be present.
- Regulatory approval: Every medicine sold in a licensed market has a regulatory registration barcode.
- Beware if the price is very low: "Campaign" offers significantly below market average increase the risk of unlicensed products.
Frequently Asked Questions
What are the botox brands?
As of 2026, the leading approved botulinum toxin type A brands are: Botox, Dysport, Xeomin, Bocouture, Azzalure, Jeuveau/Nuceiva, Daxxify, Letybo, Relfydess, Neuronox/Meditoxin and Innotox. The most widely used three brands in routine clinical practice are: Botox, Dysport and Xeomin.
What is the difference between Botox, Dysport and Xeomin?
All three brands contain botulinum toxin type A but have different formulations. Botox is 900 kDa with complex proteins; Dysport shows wider spread and faster onset; Xeomin is a 150 kDa pure formulation with no accessory proteins, storable at room temperature. Dose equivalency: Botox:Dysport = 1:2.5–3, Botox:Xeomin = 1:1.
Which Botox brand lasts the longest?
Daxxify, with an average duration of 6 months (up to 9 months in some patients), is the longest-lasting botulinum toxin brand. Relfydess also offers approximately 5–6 months of effect. Standard Botox, Dysport and Xeomin last an average of 3–4 months.
Which Botox brand is best?
There is no single "best" brand. Clinical studies show that licensed main brands (Botox, Dysport, Xeomin) are comparable in terms of aesthetic outcomes and patient satisfaction. The most appropriate brand should be determined according to the treatment area, the patient's expectations and the practitioner's experience.
Can different Botox brands be used interchangeably?
Yes, but dose equivalency must be calculated. They cannot substitute for each other on a unit-for-unit basis; each brand has its own unit system. Mixing different brands in the same session is not recommended. Brand changes should be made at the physician's discretion.
Are Jeuveau and Botox the same thing?
No. Both contain botulinum toxin type A and are structurally similar (900 kDa). However, they belong to different manufacturers: Botox is produced by Allergan and Jeuveau by Evolus. Their clinical effects are comparable; dose equivalency is approximately 1:1.
Is there a difference between Bocouture and Xeomin?
No. Bocouture and Xeomin are two different trade names for the same molecule (incobotulinumtoxinA) from Merz. Bocouture is the name used in Europe for aesthetic indications; the active substance is entirely the same.
Is Daxxify available outside the USA?
As of 2026, Daxxify is predominantly used in the US market and is not routinely licensed in all international markets. Be cautious towards centres claiming to offer Daxxify and always verify the regulatory licensing status. Use of an unlicensed product is not only illegal but poses serious health risks.
Is there a price difference between Botox brands?
Yes. Botox (Allergan) is generally in the highest price segment; Dysport and Xeomin are in the upper-mid segment. Daxxify is premium-priced due to its long duration. Jeuveau and Letybo are generally more affordable. However, brand should not be the sole selection criterion; the licensed status of the product, the practitioner's experience and suitability of dosing for the treatment area should take priority.
Which Botox brand has the lowest risk of antibody development?
Xeomin (Bocouture), by virtue of not containing accessory complex proteins, theoretically has the lowest risk of neutralising antibody development. This is particularly relevant in patients who receive frequent repeat treatments (chronic migraine, spasticity). Daxxify is also regarded as a next-generation product due to its peptide stabiliser formulation.
Conclusion: Key Rules for Botox Brand Selection
The choice between Botox brands should always be guided by the equation of practitioner experience + treatment area + licensed status + individual expectations. The 2026 clinical data show that Botox, Dysport and Xeomin perform very similarly in terms of aesthetic outcomes and safety, with differences concentrated mainly in clinical details such as diffusion width, onset speed, storage conditions and antigenic potential. Next-generation brands (Daxxify, Relfydess) offer promising developments in terms of duration of action, and their licensing status in various markets should be monitored.
For patients, the two most important steps are: (1) a procedure performed by a qualified physician at a licensed clinic and (2) checking the product vial before it is opened. The practitioner's knowledge of anatomy, dose calculation and technique are more decisive for the outcome than the brand name itself. Contact Virtuana Clinic for consultations about Botox treatments.
Related Guides
- What Is Botox? Comprehensive Guide 2026
- Botox Brand Comparison: Botox vs Dysport vs Xeomin 2026
- How Long Does Botox Last?
- Botox Unit Dosage Calculation Guide
This article has been prepared for informational purposes only and does not constitute medical advice. Botulinum toxin application requires examination and assessment by a qualified physician at a licensed healthcare facility before the procedure. The article was updated on 11 April 2026 based on FDA, EMA, ISAPS 2024 reports, Revance SAKURA phase III studies, Evolus EV-001/002 clinical studies and Merz incobotulinumtoxinA literature.