Daxxify: what it is, cost, results and how it compares to Botox

Daxxify is the brand name for daxibotulinumtoxinA-lanm, a botulinum toxin injection made by Revance.

The FDA approved it on September 7, 2022, for the temporary improvement of glabellar lines — the frown lines between the eyebrows — in adults.

A second approval, on August 11, 2023, covers cervical dystonia in adults; that is a therapeutic use, not a cosmetic one.

How the toxin acts, per the Botox Cosmetic label: it blocks acetylcholine release at nerve endings, producing a partial, localized reduction in muscle activity.

The effect is temporary because reinnervation of the muscle slowly reverses it.

Its formulation is the distinguishing feature.

Daxxify is stabilized by a 35-amino-acid peptide excipient (RTP004) and contains no human albumin, and unopened vials can be stored at room temperature (20 to 25°C) or refrigerated.

The labeled dose for frown lines is 40 units, given as five equal injections of 8 units each, with treatment no more often than every three months.

Daxxify is one of the six neuromodulator brands the American Society of Plastic Surgeons names in its 2025 statistics report, which says neuromodulator injections accounted for about half of all minimally invasive procedures performed in 2025.

Our guide to neurotoxin brands compares all of them side by side.

Daxxify and Botox are different products built for the same job, and both carry the same FDA boxed warning for spread of toxin effect.

The differences are in the formulation, the storage, the label and the trial record.

Formulation first.

Daxxify is stabilized by a peptide and contains no human albumin; Botox Cosmetic pairs the toxin with accessory proteins and contains human albumin, and its unopened vials must be stored refrigerated at 2 to 8°C.

Daxxify's unopened vials can sit at room temperature or under refrigeration.

On the label, Botox Cosmetic is approved for four cosmetic areas — frown lines, crow's feet, forehead lines and vertical neck bands — while Daxxify's only cosmetic approval is frown lines.

Their labeled frown-line doses differ by design: 20 units for Botox Cosmetic (five 4-unit injections) and 40 units for Daxxify (five 8-unit injections).

The 40 does not mean Daxxify is "twice the strength" — each label says its units cannot be compared to or converted into the other's, and there is no official conversion ratio.

On duration, the Botox Cosmetic label gives approximately 3 to 4 months for frown lines, a label statement.

Daxxify's label states no duration; the 6-month figure you may have read comes from Revance-sponsored trials, which measured medians of 24.0 and 23.9 weeks.

And the history differs: Botox was first approved in 1989, with its cosmetic frown-line approval in 2002, while Daxxify arrived in 2022.

Daxxify has one cosmetic area on its US label: glabellar lines — the frown lines, or "11s," between the eyebrows — in adults.

The labeled treatment is 40 units split across five injection points in that area.

Its only other approved use is cervical dystonia, which is medical, not cosmetic.

Everything else you may see on a menu — jaw slimming, a brow lift, crow's feet, forehead lines, the fine lines under the eyes — is an off-label use of Daxxify: that use is not on any current US label for the product.

Botox Cosmetic does carry some of those areas on its own label, so product and area do not always match on a clinic menu, and it is a fair question to ask which toxin a quoted treatment uses.

A lip flip is off-label for every neurotoxin brand: no US neurotoxin label includes the lips or the muscle around them.

Daxxify is no exception.

Offices typically price botulinum toxin treatment one of two ways: per unit, or per treatment area.

With per-unit pricing, the price of an area is roughly the number of units times the per-unit price.

The label's recommended frown-line dose is 40 units, so a labeled-dose frown-line treatment prices out at 40 times the office's per-unit rate.

Do not compare a Daxxify price per unit with a Botox price per unit.

Each brand's units are its own — the labels state they cannot be compared to or converted into each other — so the same area uses different unit counts on different products.

Compare what matters: the product, the number of units in the quote, and the total.

We could not confirm a current national average price for Daxxify or other neuromodulators.

The ASPS's 2025 statistics report omits fees for minimally invasive procedures, and other national price sources were not retrievable at our most recent check.

What moves the number: how the office structures its pricing — per unit or per area — and how many units you actually receive, so ask each office for its current price per unit and the total it expects for the areas you want treated.

Start with what the label does and does not say: it states no duration of effect, so the 6-month figure you may have read is not a label claim.

What the label does say: treatment should be given no more often than every three months, and its trial data reports treatment success at week 4.

In the two glabellar trials behind the label, 406 subjects were treated with 40 units and followed for at least 24 weeks; 74% achieved treatment success at week 4, against 0% on placebo.

In the larger Revance-sponsored published trials, SAKURA 1 and 2 — 609 adults at the same 40-unit dose — frown lines stayed none or mild for a median of 24.0 and 23.9 weeks, and the median time back to baseline severity was 27.7 and 26.0 weeks.

A pooled analysis of the two trials put the none-or-mild median at 24.0 weeks.

Those are trial medians: they describe the groups studied, not what any one person gets.

They are also not like-for-like with Botox's figure — the Botox Cosmetic label gives approximately 3 to 4 months for frown lines, a label statement, while the Daxxify numbers come from Revance-sponsored trials.

On onset, we could not confirm a labeled figure in days for Daxxify; the Botox Cosmetic label, by contrast, describes frown-line muscle relaxation typically beginning 1 to 2 days after injection.

Ask your provider when to expect your own result.

In the glabellar-line trials behind the label, the most common adverse reactions at 1% or more were headache (6%), eyelid ptosis — a drooping eyelid — (2%) and facial paresis, weakness of the facial muscles (1%).

In the pooled analysis of SAKURA 1 and 2, treatment-related headache was 6.4%, against 2.0% on placebo.

These are trial rates for the 40-unit frown-line dose, not predictions for any individual.

On antibodies, the label reports that across its phase 3 studies — 2,786 subjects receiving up to three treatments — anti-drug antibodies formed in 0.8% of subjects against the toxin and 1.2% against the peptide excipient, and no subjects developed neutralizing antibodies.

For pregnancy and breastfeeding, the labels and the FDA say safety is not established for injectables such as botulinum toxin.

Nothing here is a verdict on your own case; that is a conversation for a licensed provider who knows your history.

We do not republish star ratings on this page.

Reviews and anecdotes cannot be verified the way a label, a trial or a state rule can, and a five-star review of one injector does not tell you what the drug did in controlled trials.

What can be verified is the trial record.

In the two trials behind the label, 74% of 406 treated subjects met the treatment-success measure at week 4, against 0% of placebo subjects, and subjects were followed for at least 24 weeks.

The SAKURA pooled analysis reported frown lines staying none or mild for a median of 24.0 weeks.

Those numbers describe groups of trial subjects at a fixed 40-unit dose — not a guarantee for any individual.

If you are reading patient reviews while weighing Daxxify, keep the context in view: the reviewer's dose, injector and anatomy are not yours, and a review cannot be checked against who administered the injection or where the product came from.

Ask a provider you are vetting for before-and-after photos of their own Daxxify patients and how they dose, then hold the answers against the label and trial figures above.

Who may legally inject Daxxify is state law, and it differs by state.

AmSpa, a med spa trade association, frames the baseline: injecting a prescription drug such as botulinum toxin is the practice of medicine, so it must be done by a physician, an independent-practice nurse practitioner, or another licensed professional acting within their scope, under their state's rules.

The CDC's consumer advice is to get botulinum toxin injections only from a licensed, trained provider using product from an authorized source — and it notes that even FDA-approved product, given correctly, is "not risk-free."