Drug & supplement interaction

Mace + 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 Mace 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

Mace 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 Mace 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.

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.

Mace safety at a glance

Mace overall Use caution Safe as a culinary spice but large or concentrated doses can be toxic.
Pregnancy Possibly Unsafe When used orally in medicinal amounts. Mace might have abortifacient activity, and its safrole content might be mutagenic. Read the full pregnancy detail
Breastfeeding Use caution Food amounts are probably fine, but avoid concentrated supplements due to lack of safety data.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Botulinum Toxin Type A and Mace? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
Keep it in perspective

Mace Does Interact With Other Medications

Mace has 500 moderate known drug interactions in our database — Botulinum Toxin Type A isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Mace

Covers the 2,830 medications we’ve checked against Mace. Pick one to open its full report.

What to actually watch for

What Mace Itself Has Been Linked To

This is not an interaction — nothing below involves Botulinum Toxin Type A. It is the side-effect record for Mace on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Mace, this list is the first place to look. 3 entries are worth acting on rather than waiting out — marked below.

  • Hallucinations / Confusion Worth acting on Additional detail

    “There are no reports of adverse psychiatric events due to ingestion of mace. However, mace contains myristicin, which is structurally similar to certain hallucinogenic chemicals. High intake of nutmeg, a similar herb, has been reported to cause mild to intense visual hallucinations, auditory hallucinations, feelings of impending doom, euphoria, anxiety, disorientation, stupor, agitation, insomnia, and restlessness (1…”

    Mace · Natural Medicines adverse-effect record, reported in anxiety.

    5 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 2563. Sangalli BC, Chiang W. Toxicology of nutmeg abuse. Clin Toxicol 2000;38:671-8. PubMed
    3. 19300. Stein U, Greyer H, Hentschel H. Nutmeg (myristicin) poisoning-report on a fatal case and a series of cases recorded by a poison information centre. Forensic Sci Int 2001;118:87-90. PubMed
    4. 19489. Carstairs SD, Cantrell FL. The spice of life: an analysis of nutmeg exposures in California. Clin Toxicol (Phila) 2011;49:177-80. PubMed
    5. 19492. Abernethy MK, Becker LB. Acute nutmeg intoxication. Am J Emerg Med 1992;10:429-30. PubMed
  • Seizures Worth acting on Additional detail

    “There are no reports of adverse neurologic or central nervous system (CNS)-related events due to ingestion of mace. However, mace contains myristicin, which is structurally similar to certain hallucinogenic chemicals. High intake of nutmeg, a similar herb, has been reported to cause headache, dizziness, drowsiness, hot and cold sensations, sensations of limb loss, convulsions, and coma.”

    Mace · Natural Medicines adverse-effect record, reported in cluster headache.

    4 sources cited
    1. 2563. Sangalli BC, Chiang W. Toxicology of nutmeg abuse. Clin Toxicol 2000;38:671-8. PubMed
    2. 19294. Panayotopoulos DJ, Chisholm DD. Hallucinogenic effect of nutmeg. Br Med J 1970;1:754. PubMed
    3. 19300. Stein U, Greyer H, Hentschel H. Nutmeg (myristicin) poisoning-report on a fatal case and a series of cases recorded by a poison information centre. Forensic Sci Int 2001;118:87-90. PubMed
    4. 19487. Venables GS, Evered D, Hall R. Letter: Nutmeg poisoning. Br Med J 1976;1:96. PubMed
  • Chest pain Worth acting on Additional detail

    “There are no reports of adverse cardiovascular events due to ingestion of mace. However, mace contains myristicin, which is structurally similar to certain hallucinogenic chemicals. High intake of nutmeg, a related herb, has been associated with non-specific electrocardiographic changes, tachycardia, palpitations, weak pulse, hypotension, chest pain, and flushing (12,19293,19300,25547,25943).”

    Mace · Natural Medicines adverse-effect record, reported in hypotension.

    5 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 19293. McKenna A, Nordt SP, Ryan J. Acute nutmeg poisoning. Eur J Emerg Med 2004;11:240-1. PubMed
    3. 19300. Stein U, Greyer H, Hentschel H. Nutmeg (myristicin) poisoning-report on a fatal case and a series of cases recorded by a poison information centre. Forensic Sci Int 2001;118:87-90. PubMed
    4. 25547. Grover JK, Khandkar S, Vats V, Dhunnoo Y, Das D. Pharmacological studies on Myristica fragrans--antidiarrheal, hypnotic, analgesic and hemodynamic (blood pressure) parameters. Methods Find Exp Clin Pharmacol. 2002;24(10):675-80. PubMed
    5. 25943. Barceloux DG. Nutmeg (Myristica fragrans Houtt.). Dis Mon. 2009;55(6):373-9. PubMed
  • Flushing / A fast or pounding heartbeat / Low blood pressure Additional detail

    Recorded for Mace in the same Natural Medicines adverse-effect record shown under Chest pain above.

  • Drowsiness Additional detail

    Recorded for Mace in the same Natural Medicines adverse-effect record shown under Seizures above.

  • Anxiety or restlessness / Trouble sleeping Additional detail

    Recorded for Mace in the same Natural Medicines adverse-effect record shown under Hallucinations / Confusion above.

Showing the 10 most notable of 15 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Mace — 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.

Special populations

Mace in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally in medicinal amounts. Mace might have abortifacient activity, and its safrole content might be mutagenic.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Botulinum Toxin Type A Is Prescribed For, and What Mace Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Botulinum Toxin Type A is a prescription medicine with approved uses on its FDA label. Mace is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Botulinum Toxin Type A is prescribed for: 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.

Read the rest of what Botulinum Toxin Type A is prescribed for

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.

Mace has been studied for:

  • Urinary incontinence studied, not established Mace has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Mace for urinary incontinence

    In women with mixed urinary incontinence of at least 2 months duration, preliminary clinical research shows that taking mace powder 1.5 grams twice daily for 3 months, in addition to doing pelvic floor muscle training, has a large benefit on severity of symptoms when compared with those using pelvic floor training alone.

    1 source cited
    1. 103377. Najeeya AGF, Sultana A. Efficacy of mace (Arils of Myristica fragrans Houtt) plus PFMT on symptoms in mixed urinary incontinence: a randomized placebo-controlled trial. Integr Med Res. 2018;7(4):307-315.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Botulinum Toxin Type A on your own; if you are taking Mace for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Mace 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 Mace 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 Mace as Part of a Dietary Supplement Product? Check It for Interactions

We hold 38 real supplement products containing Mace, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Mace. Even though Mace 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 Mace 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 Mace
Steady interest

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

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

#310 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 Mace reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Mace and Botulinum Toxin Type A records this page draws on were last updated July 11, 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 Mace

What is Mace?

  • Digestive upset and gas
  • Flavoring and culinary spice
  • Nausea
  • Appetite stimulation
  • Traditional pain or muscle relief

Mace is the lacy red covering of the nutmeg seed and comes from the same tree as nutmeg. It is mostly used as a cooking spice and in traditional medicine for digestion, but there is little solid human research to support its health uses. In normal food amounts it is generally safe, but large doses can be toxic, so use it as a spice and check with your pharmacist before taking concentrated supplements.

Myristica fragrans · Myristicaceae · The dried red, lacy covering (aril) of the nutmeg seed · Whole dried blades, ground powder, essential oil, capsules

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

Mace: dosing

There is no established standardized medicinal dose for mace. As a spice, the amount used in cooking is small and considered safe.If you choose to use a mace supplement, follow the directions on the product label and do not exceed them. Because high amounts can be toxic, more is not better.

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

Read the full Mace 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 & Mace

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

0Major
500Moderate
0Minor
2,329No known interaction
Moderate

500 interactions

Showing 60 of 500 moderate interactions — see all 500 on the Mace page.

No interaction 2,329 drugs checked — show the list
Evidence & sources

Mace References

The 18 references that drive our Mace 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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Sangalli BC, Chiang W. Toxicology of nutmeg abuse. Clin Toxicol 2000;38:671-8. PubMed
  3. Hallstrom H, Thuvander A. Toxicological evaluation of myristicin. Nat Toxins 1997;5:186-92. DOI
  4. Jeong HG, Yun CH. Induction of rat hepatic cytochrome P450 enzymes by myristicin. Biochem Biophys Res Commun 1995;217:966-71. PubMed
  5. McKenna A, Nordt SP, Ryan J. Acute nutmeg poisoning. Eur J Emerg Med 2004;11:240-1. PubMed
  6. Panayotopoulos DJ, Chisholm DD. Hallucinogenic effect of nutmeg. Br Med J 1970;1:754. PubMed
  7. Stein U, Greyer H, Hentschel H. Nutmeg (myristicin) poisoning-report on a fatal case and a series of cases recorded by a poison information centre. Forensic Sci Int 2001;118:87-90. PubMed
  8. Venables GS, Evered D, Hall R. Letter: Nutmeg poisoning. Br Med J 1976;1:96. PubMed
  9. Carstairs SD, Cantrell FL. The spice of life: an analysis of nutmeg exposures in California. Clin Toxicol (Phila) 2011;49:177-80. PubMed
  10. Abernethy MK, Becker LB. Acute nutmeg intoxication. Am J Emerg Med 1992;10:429-30. PubMed
  11. Checker R, Chatterjee S, Sharma D, et al. Immunomodulatory and radioprotective effects of lignans derived from fresh nutmeg mace (Myristica fragrans) in mammalian splenocytes. Int Immunopharmacol. 2008;8(5):661-669. PubMed
  12. Sell AB, Carlini EA. Anesthetic action of methyleugenol and other eugenol derivatives. Pharmacology. 1976;14(4):367-77. PubMed
  13. Fundarò A, Cassone MC. [Action of essential oils of chamomile, cinnamon, absinthium, mace and origanum on operant conditioning behavior of the rat]. Boll Soc Ital Biol Sper. 1980;56(22):2375-80.
  14. Grover JK, Khandkar S, Vats V, Dhunnoo Y, Das D. Pharmacological studies on Myristica fragrans--antidiarrheal, hypnotic, analgesic and hemodynamic (blood pressure) parameters. Methods Find Exp Clin Pharmacol. 2002;24(10):675-80. PubMed
  15. Barceloux DG. Nutmeg (Myristica fragrans Houtt.). Dis Mon. 2009;55(6):373-9. PubMed

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 Mace and Botulinum Toxin Type A Together: Common Questions

Is it safe to take Mace with Botulinum Toxin Type A?
We do not list a known interaction between Mace 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.
Are Mace and Botulinum Toxin Type A used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Mace in each. That is a conversation for your prescriber, especially if Botulinum Toxin Type A is being adjusted to a target.
Does Mace interact with any other medications?
Yes. Mace has 500 documented drug interactions in our database — Botulinum Toxin Type A is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

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

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

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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.