At a glance
Clostridium Botulinum Toxin Type A Neurotoxin is a neurotoxin used for the treatment of muscle spasm, strabismus, blepharospasm, cervical dystonia, chronic migraine, overactive bladder, and glabellar and canthal lines for cosmetic purposes.
Indications
- Muscle spasm
- Strabismus
- Blepharospasm
- Achalasia
- Cervical dystonia
- Limb spasticity
- Overactive bladder
- Chronic migraine
- Severe Primary Axillary Hyperhidrosis
- Glabellar and lateral Canthal lines (cosmetic purpose)
Pharmacology
Neurotoxin from Clostridium botulinum; prevents ACh release from presynaptic membrane, causing temporary calming of muscle contractions by blocking the transmission of nerve impulses. Botulinum Toxin Type A blocks the signals between the nerve & its muscle, reducing limb tightness and allowing the muscle a better chance to grow normally. This therapy can delay surgery by encouraging normal movement.
Dosage
Adult Dose:
| Indication | Dose | Details |
|---|---|---|
| Glabellar lines | 20 units | 4 units (0.1 mL) into each of 5 sites |
| Canthal lines | 24 units/0.6 mL | 3 sites per side (6 total), 4 units/site |
| Blepharospasm | 1.25-2.5 units | IM; not to exceed 200 units in 30 days |
| Strabismus | 1.25-5 units | IM; <25 units per injection |
| Chronic Migraine | 155 units | Across 7 head/neck muscles q12wk |
| Overactive Bladder | 100 units | 20 injections of 5 units each |
| Axillary Hyperhidrosis | 50 units | Intradermally to each axilla |
| Cervical Dystonia | 25-200 units | Depending on muscle groups; max 6 U/kg every 2 months |
Side effects
Common Side Effects:
- Skin rash
- Chills
- Muscle cramps
- Back pain
- Fever
- Nausea
- Vomiting
- Wheezing
Use in pregnancy
Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Patients should be well hydrated prior to administration.
- Assess renal function (BUN or serum creatinine) prior to initial infusion.
- Periodic monitoring of renal function tests and urine output is important in patients at risk for acute renal failure.
- Monitor the patient's vital signs continuously during administration.
- Do not exceed the recommended infusion rate.
Overdose effects
Botulinum Toxin Type A overdose may cause muscle weakness, respiratory distress, and difficulty swallowing. Seek immediate medical attention if overdose is suspected.
Storage conditions
Store at the recommended temperature. Keep away from light and out of reach of children.