Posted by: Thixia | October 25, 2008

Botulinum Toxin Type B Injection



(bott’ you lye num)


Other Names: Myobloc®, BoNT-B, BTB



Why is this medication prescribed?


Botulinum toxin type B is used to relieve the symptoms of cervical dystonia (spasmodic torticollis; uncontrollable tightening of the neck muscles that may cause neck pain and abnormal head positions). Botulinum toxin type B is in a class of medications called neurotoxins. It works by blocking the nerve signals that cause uncontrollable tightening and movement of the muscle.



How should this medicine be used?

What special precautions should I follow?What special dietary instructions should I follow?

What side effects can this medication cause?


Botulinum toxin type B may cause side effects.


Tell your doctor if any of these symptoms are severe or do not go away:


  • pain in the area where the medication was injected
  • back or joint pain
  • headache
  • dizziness
  • nausea     
  • heartburn
  • dry mouth



Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:


  • shortness of breath
  • difficulty breathing, swallowing, or talking
  • weakness
  • weakness or numbness of the arms or legs
  • difficulty holding the head up
  • fever, cough, and other signs of infection


Botulinum toxin type B has caused severe, life-threatening breathing problems and death. These symptoms occurred as soon as one day and as late as several weeks after botulinum toxin type B injections were given. These problems may have occurred when botulinum toxin type B spread through the body and affected areas other than the muscles that were being treated. Talk to your doctor about the risks of receiving this medication.



Botulinum toxin type B may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.



What other information should I know?


  • Keep all appointments with your doctor.
  • It is important for you to keep a written list of all of the prescription and non-prescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
  • You should take this list with you each time you visit a doctor or if you are admitted to a hospital.
  • It is also important information to carry with you in case of emergencies.



Before receiving botulinum toxin type B, tell your doctor and pharmacist if you are allergic to botulinum toxin type B, botulinum toxin type A (Botox), any other medications, or any of the ingredients in botulinum toxin type B injection. Ask your pharmacist for a list of the ingredients.  


Tell your doctor and pharmacist what prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.  Be sure to mention certain antibiotics such as:


  • amikacin,
  • gentamicin,
  • kanamycin,
  • neomycin (Neo-Rx, Neo-Fradin),
  • streptomycin, or tobramycin (Tobi) and


cholinesterase inhibitors such as ambenonium (Mytelase),

  • donepezil (Aricept),
  • galantamine (Razadyne),
  • neostigmine (Prostigmin),
  • physostigmine,
  • pyridostigmine (Mestinon,
  • Regonol),
  • rivastigmine (Exelon) and
  • tacrine (Cognex).


Also tell your doctor if you have received botulinum toxin type A (Botox) in the past several months. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor if you have or have ever had any condition that affects your muscles or nerves such as:


  • amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease; condition in which the nerves that control muscle movement slowly die, causing the muscles to shrink and weaken),
  • motor neuropathy (condition in which the muscles weaken over time),
  • myasthenia gravis (condition that causes certain muscles to weaken, especially after activity), or
  • Lambert-Eaton syndrome (condition that causes muscle weakness that may improve with activity).


Also tell your doctor about all the other medications and treatments you have used to treat your condition, especially botulinum toxin type A (Botox).


Tell your doctor


if you are pregnant,

plan to become pregnant, or

are breast-feeding.


If you become pregnant while receiving botulinum toxin type B, call your doctor.


if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving botulinum toxin type B.




Unless your doctor tells you otherwise, continue your normal diet.





Botulinum toxin type B comes as a liquid to be injected into a muscle by a doctor. Your doctor will choose the best place to inject the medication in order to treat your condition. You will receive one to four injections into each affected muscle, depending on the size of the muscle. You may receive additional injections of botulinum toxin type B every 3-4 months, depending on your response to the medication.

Your doctor may use an anesthetic cream to numb your skin or may give you a sedative to relax you before injecting botulinum toxin type B.


Botulinum toxin type B controls cervical dystonia but does not cure it. You may notice improvement in your symptoms within 2 weeks, but it may take several treatment sessions for you to feel the full benefit of the medication. The effects of the treatment may last 12-16 weeks, and then you may need to receive another set of injections to control your symptoms.



Ask your doctor for a copy of the manufacturer’s information for the patient.



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