Botulinum Toxin Type A (OnabotulinumtoxinA)(bot’ yoo lin um)
Botox, Botox Cosmetic, Dysport, Xeomin
PREGNANCY CATEGORY C
Drug class
Neurotoxin
Therapeutic Actions
Blocks neuromuscular transmission by binding to receptor sites on the motor nerve terminals and inhibiting the release of acetylcholine; this blocking results in localized muscle denervation, which causes local muscle paralysis; this denervation can lead to muscle atrophy and reinnervation if the muscle develops new acetylcholine receptors.
Indications
Temporary improvement in the appearance of moderate to severe glabellar lines—associated with corrugator or procerus muscle activity in adults 65 yr and younger (Botox Cosmetic, Dysport, Xeomin)
Treatment of cervical dystonia in adults to decrease severity of abnormal head position and neck pain (Botox, Dysport, Xeomin)
Treatment of severe primary axillary hyperhidrosis that is not adequately managed with topical agents (Botox only)
Treatment of strabismus and blepharospasm associated with dystonia in patients 12 yr and older (Botox only)
Treatment of spasticity of the elbow, wrist, and fingers in adults following stroke, traumatic brain injury, progression of multiple sclerosis (Botox only)
Prophylaxis of headaches in adults with chronic migraines (at least 15 days/month lasting 4 hr a day or longer) (Botox only)
Treatment of blepharospasm in adults previously treated with Botox (Xeomin only).
Treatment of urinary incontinence in patients with neurological conditions, such as spinal cord injury or MS, who have overactive bladder (Botox)
NEW INDICATION: Treatment of overactive bladder in patients who cannot take anticholinergics
Unlabeled uses: Achalasia, cosmetic improvement of facial lines and wrinkles, gustatory sweating, hand dystonia, tension headache, palmar hyperhidrosis, sialorrhea
Contraindications and Cautions
Contraindicated with hypersensitivity to any component of the drug, active infection at the injection site area.
Use cautiously with peripheral neuropathic diseases (amyotrophic lateral sclerosis [ALS], motor neuropathies); neuromuscular disorders such as myasthenia gravis; inflammation in the injection area; compromised respiratory function, bronchitis, or URIs when used for limb spasticity; lactation, pregnancy; known CV disease.
Available Forms
Powder for injection—50, 100, 200, 300, 500 units/vial
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