Posted by: Thixia | October 24, 2008

Botulinum Toxin Type A (Botox)

Brand Name

Common Name
 botulinum toxin type A

How does this medication work? What will it do for me?


Botulinum toxin is a neuromuscular paralytic agent. It blocks the nerves that are responsible for muscle activity and helps to relax muscles that are in constant contraction (spasm). It is used to treat conditions that are caused by certain muscles going into spasm. These include:

*       blepharospasm, a condition where the eyelid will not stay open because of a spasm of a muscle in the eye

*       strabismus, a condition in which the eyes do not line up properly

*       cervical dystonia, also known as spasmodic torticollis, a condition in which the muscles of the neck stay in a state of contraction

*       dynamic equinus foot deformity due to spasms in pediatric cerebral palsy patients 2 years of age or older

*       focal spasticity such as arm spasms after a stroke


It is also used to treat a condition called hyperhidrosis, which is excessive underarm sweating.


Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. Do not stop taking this medication without consulting your doctor.

How should I use this medication?


Botulinum toxin is always injected into a muscle by a qualified health professional. When given for conditions of the eye, the medication is injected into the surrounding muscle or tissue of the eye.

The dose of medication required depends on the condition being treated and individual circumstances. More than one dose may be required, depending on the condition being treated. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications.


It is important that you keep appointments for the administration of this medication and for follow-up.

The dried product should be stored in a refrigerator at 2°C to 8°C, or in a freezer at or below -5°C, and used within four hours after removal from the freezer. The dried product should be diluted with the supplied solution after removal from the freezer and kept in the refrigerator until used.

What form(s) does this medication come in?

Each vial contains Clostridium botulinum toxin type A 100 units (U), albumin (human) 0.5 mg and sodium chloride 0.9 mg in a sterile, vacuum-dried form without a preservative.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take this medication?


Botulinum toxin should not be used by anyone who:

*       is sensitive or allergic to botulinum toxin or to any of the ingredients of this medication

*       has myasthenia gravis or Eaton Lambert syndrome

*       has an infection at the site the injection is to be given

What side effects are possible with this medication?


Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.


The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.


Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.


When used for blepharospasm:

*       drooping of the upper eyelid

*       irritation or watering of the eye

*       pain, soreness or bruising at the place of injection

*       sensitivity of the eye to light


When used for strabismus:

*       drooping of the upper eyelid

*       eye pointing upward or downward instead of straight ahead

*       pain, soreness or bruising at the place of injection


When used for cervical dystonia:

*       drooping eyelid

*       drowsiness

*       dry mouth

*       fever

*       flu symptoms

*       headache

*       local or general weakness

*       muscle tightness

*       nausea

*       numbness

*       pain, soreness or bruising at the place of injection

*       runny nose

*       stiffness


When used for spasticity associated with cerebral palsy:

*       fever

*       knee or ankle pain

*       leg pain

*       leg cramps

*       local or general weakness

*       pain, soreness or bruising at the place of injection

*       tiredness


When used to treat excessive sweating:

*       increased sweating in areas other than under the arms

*       pain, soreness or bruising at the place of injection


When used for focal spasticity:

*       arm pain

*       fever

*       flu symptoms

*       muscle tightness or weakness

*       pain, soreness or bruising at the place of injection


Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.


Check with your doctor as soon as possible if any of the following side effects occur:

*       difficult or painful swallowing, dizziness, shortness of breath or vision changes (when used for cervical dystonia)

*       facial paralysis or persistent eye irritation or pain (when used for eye conditions)

*       falling (when used for spasticity due to cerebral palsy)

*       fever, especially when accompanied by coughing and shortness of breath

*       irregular heart beat

*       shortness of breath

*       skin rash


Seek immediate medical attention if any of the following occur:

*       peeling, blistering skin

*       signs of an allergic reaction (hives, difficulty breathing, swelling of the mouth, tongue or throat)

*       signs of a heart attack (chest pain or pressure; shortness of breath; jaw, shoulder or arm pain; nausea; lightheadedness; sweating)


Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are using this medication.

Are there any other precautions or warnings for this medication?


Be sure to inform your doctor of all your medical conditions before you begin taking a medication. Some conditions can affect how you should take this medication.


Angle-closure glaucoma:

Botulinum toxin can cause angle-closure glaucoma in those at risk. Your doctor will monitor for this if necessary.

Difficulty swallowing: If you develop severe difficulty swallowing while using this medication, contact your doctor immediately.

Other medical conditions: This medication may worsen amyotrophic lateral sclerosis, disorders that produce a depletion of acetylcholine, or certain neuromuscular disorders. People with these conditions should be closely monitored by their doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.


What other drugs could interact with this medication?


The following medications may affect how botulinum toxin works or increase the risk of side effects:


*       aminoglycoside antibiotics (e.g., gentamicin, neomycin, tobramycin, streptomycin)

*       lincomycin

*       muscle relaxants (tubocuraine-type)

*       spectinomycin

*       tetracyclines


If you are taking any of these medications, speak with your doctor or pharmacist.

Depending on your specific circumstances, your doctor may want you to:

*       stop taking one of the medications,

*       change one of the medications to another,

*       change how you are taking one or both of the medications, or

*       leave everything as is.


An interaction between two medications does not always mean that you must stop taking one of them.

In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.


Medications other than those listed above may interact with this medication.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.






The contents of this site are for informational purposes only and are meant to be discussed with your physician or other qualified health care professional before being acted on. Never disregard any advice given to you by your doctor or other qualified health care professional. Always seek the advice of a physician or other licensed health care professional regarding any questions you have about your medical condition(s) and treatment(s). This site is not a substitute for medical advice.
© 1996 – 2008 MediResource Inc. – Targeted Health Solutions



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