I read with great interest the letter submitted by Malhotra et al regarding the use of HSA in botulinum toxin products. As Malhotra and colleagues correctly note, the use of HSA as an excipient is stated on the label of Allergan's botulinum toxin type A.
As the manufacturer of Botox, Allergan offers the highest-quality product and provides physicians with detailed information on its safe use. Botox has more than 20 years of successful clinical use in millions of patients worldwide for a variety of therapeutic and cosmetic conditions. More than 75 regulatory agencies around the world have studied and approved the product. It has been approved in the United States since 1989 and throughout Europe during the 1990s. It is within the professional judgment of physicians to inform patients of the benefits and risks prior to use or administration of any medications.
Brin MF. Botulinum Toxin and Human Serum Albumin—Reply. Arch Ophthalmol. 2003;121(11):1661-1662. doi:10.1001/archopht.121.11.1661-a