Used far too much benzyl alcohol making bacteriostatic water - numbness/swelling around injection points. Potential for damage?

[JohnBoy2000]

Not the first absent minded mistake I've made (the other main one being using 200 mg meth instead of 20 mg).

In this case I was reconstituting botox and decided to use a 1 ml syringe to add 2.5 ml saline to the botox vial, then administer the botox using my 0.5 ml shorter needle syringes (way easier and more precise for delivery).

Anyways, as I normally use all the botox in one session I didn't have pre-made/filtered bac water, I normally just add in the 1% benzyl alcohol to the saline in the vial..... how many people do.

i.e. I didn't have the pre bac water solution (saline + benzyl alcohol, filtered) made up, just made it on the spot, without filtering.

For botox injections benzyl alcohol contributes an anaesthetic component, making the injections virtual painless.

..........

Anyways, I got the "ticks" or marking on the 1 ml syringe confused with those on the 0.5 ml syringe, and basically added 8 "ticks" worth of alcohol, where it should have only been 2.5 (I normally round it off to 3);

i.e. 1 tick alcohol for every 100 ticks of saline.

So my solution basically had 3.5 % benzyl alcohol instead of 1%.

Doesn't sound like much but as the injections are done quickly, I could tell immediately after something was off.
Way more swollen and increased irritation than normal.

Then the swelling and numbness persisted into the next day (no real irritation or redness though).
And day four, it's gradually improving but still present.

........

Conventional response may be, "no worries, it's all good".
Then I'm reading some literature on benzyl alcohol and some contend its use at all is questionable, can be toxic at high doses, powerful irritant, etc.

Almost certainly a difficult question to answer without extensive medical experience and knowledge, but any general thoughts?
Anyone made the same mistake, experienced similar symptoms but no long term issues?

Potential for damage from such an error?

 

[Serotonin101]

Only experience I can give may be similar to yours as others reported similar issues and it was remarked it was due to excessive BA. It was from a batch of gear that was made by a novice brewer. I had similar experience: lots of swelling and some weird tactile weirdness. It resolved after about a week. I ended up cutting it with another product to make it bearable. Not nearly as bad as finding out I have ethyl oleate sensitivity. That was awful, I couldn't walk right for approximately 2 weeks..
I didn't have any lasting issues from the high BA gear shot and other buyers on the forum didn't seem to have long lasting issues either.

 

[JohnBoy2000]

Only experience I can give may be similar to yours as others reported similar issues and it was remarked it was due to excessive BA. It was from a batch of gear that was made by a novice brewer. I had similar experience: lots of swelling and some weird tactile weirdness. It resolved after about a week. I ended up cutting it with another product to make it bearable. Not nearly as bad as finding out I have ethyl oleate sensitivity. That was awful, I couldn't walk right for approximately 2 weeks..
I didn't have any lasting issues from the high BA gear shot and other buyers on the forum didn't seem to have long lasting issues either.

Sounds about consistent with how this is progressing, I'm approaching day 4, the numbness has subsided significantly, swelling still present but also reducing (reduction of undereye swelling makes it much more tolerable).

As BA is actually used for the purpose of inducing tissue-damage in cases of unsightly vasculature in the legs etc., I was concerned that or potential nerve damage may be an outcome.

But the way the numbness is reducing makes me optimistic symptoms should resolve without lasting issue.

.......

I think to avoid this in future I should just compound Bacteriostatic water before mixing, instead of adding benzyl alcohol to the saline mix after reconstitution.

 

[Serotonin101]

Sounds about consistent with how this is progressing, I'm approaching day 4, the numbness has subsided significantly, swelling still present but also reducing (reduction of undereye swelling makes it much more tolerable).

As BA is actually used for the purpose of inducing tissue-damage in cases of unsightly vasculature in the legs etc., I was concerned that or potential nerve damage may be an outcome.

But the way the numbness is reducing makes me optimistic symptoms should resolve without lasting issue.

.......

I think to avoid this in future I should just compound Bacteriostatic water before mixing, instead of adding benzyl alcohol to the saline mix after reconstitution.

That's what I'd do personally, as if you mess up calculations, you can just toss the homemade bac stat water instead of a reconstituted solution with more expensive product in it. Best wishes my friend.

 

[JohnBoy2000]

Just as a quick note - due to how user friendly Xenforo and therefore Bluelight is, I use it to document information accumulation on topics such as this.

I figure others can potentially benefit from said info also as well as being a reference source for myself when I encounter issues in future.

I mention that to explain why I seem to be persistently posting information/paper links in a bunch of threads here (in fact I think about 5 of the most recent 10 threads in this subforum were all created by myself).

..........

In this particular case, thankfully symptoms are noticeably subsiding - swelling, numbness etc.

However, the effect of the botox is almost negligible.

I figured this was attributable to the swelling, perhaps increased fluid in the area affected botox concentration or something.

However, it appears alcohol in and of itself, effects the potency of botox.

Botox: General Principles of Treatment

Review with the patient the exact aesthetic goals and whether the patient is abstinent from all blood thinners for a week. The physician wipes all makeup off the patient with an alcohol pad before starting, ensuring that the alcohol has time to evaporate before Botox...

link.springer.com

 

[JohnBoy2000]

It seems it's also recommended to not consume alcohol before/after receiving botox, so as not to impact efficacy of the treatment.

Manufacturers such as Allergan specifically state to use non-preserved saline when reconstituting botox, but this is the first I've read/heard of the rationale behind this.

Pffffff, obviously I'm going to try this in future. I guess we'll see how much more the effect of the botox is with just regular saline versus bacteriostatic water.

.......

I wonder would benzyl alcohol have been impacting the quality of other peptides such as melanotan 2 that I normally use it with also?

 

[JohnBoy2000]

Conversely:

NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals

NEJM Journal Watch reviews over 250 scientific and medical journals to present important clinical research findings and insightful commentary

www.jwatch.org

Fifteen other patients participated in a randomized, double-blinded study in which they received botulinum toxin A 1) reconstituted with preservative-free saline on one side of the face and botulinum toxin A 2) reconstituted with saline and preservative on the other side. These patients were asked to compare the pain of injection on each side. All patients reported less pain on the saline-and-preservative side, with an. average reduction in pain of 46%. In follow-up self-reports and subsequent clinic visits, no differences were found in efficacy, adverse effects, or duration of effect between the two sites.

Apparently some studies show no difference in efficacy between benzyl alcohol use versus without.

 

[Serotonin101]

Conversely:

NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals

NEJM Journal Watch reviews over 250 scientific and medical journals to present important clinical research findings and insightful commentary

www.jwatch.org

Apparently some studies show no difference in efficacy between benzyl alcohol use versus without.

Hmmm maybe the benzyl group has an impact since it's not just an alkane with a hydroxyl group on it anymore: it's a benzene with a hydroxyl group.

 

[JohnBoy2000]

Hmmm maybe the benzyl group has an impact since it's not just an alkane with a hydroxyl group on it anymore: it's a benzene with a hydroxyl group.

Do you mean how the BA interacts with the saline, or with the toxin?
Benzyl modified to benzene?

You wouldn't have molecule graphs to explain that by chance?

It's been a long time since I've had an organic chemistry class.

...........

Re the effect, it's commonly reported on botox DIY facebook groups that users freeze some of their remaining botox and use it a month later, sometimes more, with little to no impact on efficacy.

In this instance, I used the remaining botox I had from this administration, the botox re-constituted with 3% benzyl alcohol, except of course I diluted it by 100%;

So I was injecting 1.5% benzyl alcohol instead of 3%, just doubled up the volume for comparable effects.

Zero swelling or irritation response on this occasion.

However, there was no effect.

The botox originally reconstituted with 3% benzyl alcohol in saline, was basically non-functioning, zero effect on muscle movement.

........

Which indicates to me that yes, some benzyl alcohol does indeed to have an impact on the efficacy of botox, neutralizes it.

Possible considerations being:

1) the benzyl alcohol I used was bought off e-bay (will post screen shot later, it has its molecular chain printed on the label). That may be somehow not entirely genuine or correct BA contaminating/neutralizing the toxin

2) That's all I can think of.

.......

Will know for sure when I use my next botox injections in a week or two, reconstituted exclusively with saline.

 

[JohnBoy2000]

This has subsequently been making me question could BA have an impact on the efficacy of other peptides (melanotan being that of consideration in my case).

Many contend BA preserves the peptide or protein not only in terms of conserving sterility, but prevents bacteria from forming and acting to degrade the peptide.

Unsure of how true that is however.

If it were just a sterility issue, that wouldn't apply quite as much in my case as I use a nasal inhaler exclusively for the administration of melanotan 2.

.......

Curious if used just saline exclusively in future for MT2, would I get a more effective result (preclude BA impacting potency of the peptide).

.........

Pretty much speculation as no doubt botox behaves very different to melanotan but, I realistically don't have the insights to answer that question.

 

[Serotonin101]

My comment was in respect to how it interacts with the toxin. Traditional "alcohols" we think of are like: c-c-c-oh. A linear alkane with one of the hydrogen substituted with -oh, Ethanol c-c-oh.
Benzyl alcohol would be... Let's see if it works

............... C
............ C....C
............ C....C
................C
.................|
................C--OH
The benze ring being an aromatic changes its activity due to its size but also I'd imagine it's ability to stabilize charge (if memory serves right). So where a normal alcohol may be able to bind with a site to deactivate the toxin, the benzene ring may interfere with thay binding. I'm speaking strictly from speculation and I could be completely wrong here.

 

[JohnBoy2000]

Could well be.

Conventional bac water is obviously formulated specifically to 0.9% BA.

Which is extremely specific, perhaps for a reason?

With homemade bac water, obviously it's difficult to get that correct.

Certainly as I've been formulating mine it's been more so about 1.5%.

It's possible I guess the excess BA has been having some kind of negative impact - it certainly appears so at this point.
In any case, I'm using saline exclusively in future for Botox.

........

Question I'm asking myself now is, perhaps BA impacts the efficacy of melanotan 2 also?

And how much would bac water be necessary of it's just for the nasal spray formulation of melanotan 2?