It is important to follow and maintain the optimum storage conditions of Botox. Botox can be safely stored in large quantities for easy access, at room temperature before the applications first usage. Once the Botox solution is made up for the first time, it must be stored in the refrigerator to ensure maximum sterility of its key active ingredients, the neurotoxin from Clostridium botulinum bacteria. It is this neurotoxin that numbs or paralyses muscles that are subject to spasms.