Drug & supplement interaction

Costus + Botulinum Toxin Type A

Botulinum Toxin Type A brand name: Botox.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Costus and Botulinum Toxin Type A in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Costus and Botulinum Toxin Type A

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Botulinum Toxin Type A and Costus in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Costus at all — not against Botulinum Toxin Type A, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Costus safety at a glance

Costus overall Use caution Human safety data are limited, and quality and purity of products vary widely.
Pregnancy Avoid Traditionally believed to stimulate the uterus, so it is best avoided during pregnancy.
Breastfeeding Avoid There is not enough safety information, so avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Botulinum Toxin Type A and Costus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Costus Itself Has Been Linked To

This is not an interaction — nothing below involves Botulinum Toxin Type A. It is the side-effect record for Costus on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Costus, this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • An allergic reaction Worth acting on Additional detail

    “Orally and topically, costus might cause allergic reactions, including contact dermatitis (11,73140,73155,73281,73284,73288).”

    Costus · Natural Medicines adverse-effect record, reported in dermatitis.

    6 sources cited
    1. 11. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
    2. 73140. Marzulli, F. N. and Maibach, H. I. Effects of vehicles and elicitation concentration in contact dermatitis testing. I. Experimental contact sensitization in humans. Contact Dermatitis 1976;2(6):325-329. PubMed
    3. 73155. Mitchell, J. C. Contact hypersensitivity to some perfume materials. Contact Dermatitis 1975;1(4):196-199. PubMed
    4. 73281. Benezra, C. and Epstein, W. L. Molecular recognition patterns of sesquiterpene lactones in costus-sensitive patients. Contact Dermatitis 1986;15(4):223-230. PubMed
    5. 73284. Mitchell, J. C. and Epstein, W. L. Contact hypersensitivity to a perfume material, Costus Absolute. The role of sesquiterpene lactones. Arch.Dermatol 1974;110(6):871-873. DOI
    6. 73288. Cheminat, A., Stampf, J. L., Benezra, C., Farrall, M. J., and Frechet, J. M. Allergic contact dermatitis to costus: removal of haptens with polymers. Acta Derm.Venereol. 1981;61(6):525-529. DOI
  • A skin rash Additional detail

    Recorded for Costus in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

Everything above comes from the Natural Medicines adverse-effect record for Costus — expand a row for the licensed statement it rests on. We haven’t matched Botulinum Toxin Type A to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Botulinum Toxin Type A.

From our Q&A

Questions About Costus or Botulinum Toxin Type A

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Costus or Botulinum Toxin Type A, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

One more smart check

Taking Costus as Part of a Dietary Supplement Product? Check It for Interactions

We hold 113 real supplement products containing Costus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Costus. Even though Costus itself has no known interaction with Botulinum Toxin Type A, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Costus and Botulinum Toxin Type A Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Costus
Top half

#648 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Botulinum Toxin Type A
Top 25%

#394 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Costus reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Costus and Botulinum Toxin Type A records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Costus

What is Costus?

  • Digestive upset and gas
  • Cough and breathing complaints
  • Skin conditions (topical)
  • Worm and parasite remedies (traditional)
  • General tonic in traditional medicine

Costus (Saussurea costus) is a root used in Ayurvedic, Unani, and traditional Chinese medicine, mostly for digestive and respiratory complaints. High-quality human evidence is very limited, so its benefits are not well proven. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Saussurea costus · Asteraceae · Dried roots and root essential oil · Dried root powder, capsules, decoctions (teas), essential oil, and topical pastes

An interaction check asks whether these two react with each other — it does not ask whether Costus is a good idea for someone in your situation. Here is what our Costus record says about it on its own.

Costus: dosing

There is no well-established or standardized dose of costus for any health condition. Traditional preparations vary widely, and the strength of commercial products is not consistent.If you choose to use a costus product, follow the directions on the label and do not exceed them. The essential oil is very concentrated and should not be taken by mouth without professional guidance.

From our Costus monograph — the full record covers uses, side effects and every documented interaction.

Read the full Costus monograph & all interactions
Medication

About OnabotulinumtoxinA Injection

What Is OnabotulinumtoxinA Injection Used For?

Brand name: Botox

Botox is approved to treat a wide range of conditions in adults and some children. These include overactive bladder (OAB) with urge incontinence, urinary incontinence caused by nerve-related bladder overactivity (in adults and in children aged 5 and older), prevention of headaches in adults with chronic migraine (15 or more headache days per month), muscle stiffness (spasticity) in patients aged 2 and older, cervical dystonia (abnormal head position and neck pain), severe underarm sweating (primary axillary hyperhidrosis) when topical treatments haven't worked, eyelid spasms (blepharospasm) in patients aged 12 and older, and crossed eyes (strabismus) in patients aged 12 and older.

BOTOX Cosmetic is a separate product containing the same active ingredient but with its own approved cosmetic uses. Both products are given by injection and are not interchangeable with other botulinum toxin products. Botox has not been shown to work for episodic migraine (14 or fewer headache days per month), and its safety for excessive sweating in body areas other than the underarms has not been established.

Most-Reported Side Effects for Botulinum Toxin Type A

From FAERS, the FDA’s public side-effect reporting system (12,344 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Headache 1,596 reports
Drug intolerance 1,333 reports
Nausea 1,266 reports
Migraine 1,176 reports
Dizziness 1,126 reports
See full OnabotulinumtoxinA Injection drug information
Keep checking

Other Drugs & Costus

Browse every other medication we’ve checked against Costus — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Costus References

The 6 references that drive our Costus monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Marzulli, F. N. and Maibach, H. I. Effects of vehicles and elicitation concentration in contact dermatitis testing. I. Experimental contact sensitization in humans. Contact Dermatitis 1976;2(6):325-329. PubMed
  3. Mitchell, J. C. Contact hypersensitivity to some perfume materials. Contact Dermatitis 1975;1(4):196-199. PubMed
  4. Benezra, C. and Epstein, W. L. Molecular recognition patterns of sesquiterpene lactones in costus-sensitive patients. Contact Dermatitis 1986;15(4):223-230. PubMed
  5. Mitchell, J. C. and Epstein, W. L. Contact hypersensitivity to a perfume material, Costus Absolute. The role of sesquiterpene lactones. Arch.Dermatol 1974;110(6):871-873. DOI
  6. Cheminat, A., Stampf, J. L., Benezra, C., Farrall, M. J., and Frechet, J. M. Allergic contact dermatitis to costus: removal of haptens with polymers. Acta Derm.Venereol. 1981;61(6):525-529. DOI

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Costus and Botulinum Toxin Type A Together: Common Questions

Is it safe to take Costus with Botulinum Toxin Type A?
We do not list a known interaction between Costus and Botulinum Toxin Type A. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Botulinum Toxin Type A and Costus?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.