February 2017

Can NPs order and administer Botox?

I am an NP working in independent practice. Can I order and administer Botox via injection for cosmetic purposes?

Yes, NPs have the legal authority to prescribe and administer by injection, botulinum toxin (Botox).

When performing these activities, NPs are expected to apply the requirements outlined in the Nurse Practitioner practice standard. These include ensuring that:

  • the treatment is evidence-informed and appropriate for the client,

  • the NP has a professional relationship with the client, and

  • the treatment is provided for therapeutic purposes.

Having the authority to prescribe and administer Botox does not mean that it is always appropriate for an NP to do so. As outlined in Decisions About Procedures and Authority, NPs should consider whether they:

  • have the knowledge, skill and judgment to perform and manage all the possible outcomes of the procedure

  • are the most appropriate care provider

  • have the resources available to perform the procedure safely.

NPs in independent practice must ensure that they are practising according to all College standards and applicable laws. For example, the Nurse Practitioner practice standard outlines the only circumstances in which NPs can sell medications to clients, and the expectations for preventing conflict of interest. The Independent Practice guideline and the Professional Misconduct document highlight what NPs should consider in independent practice.

NPs are encouraged to review all College standards and guidelines and other requirements to ensure whatever practice they engage in is consistent with their professional accountabilities.  

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