Botulinum Toxin (A & B)
- TRADE NAMES: Azzalure (Galderma); Bocouture (Merz); Botox (Allergan); Dysport (Ipsen); Myobloc (Solstice); Neurobloc (Eisai); Vistabel (Allergan); Xeomin (Merz)
- INDICATIONS: Blepharospasm, hemifacial spasm, spasmodic torticollis, sialorrhea, hyperhidrosis, strabismus, oromandibular dystonia, cervical dystonia, spasmodic dysphonia, chronic migraine; urinary incontinence in people with neurologic conditions such as spinal cord injury and multiple sclerosis who have overactivity of the bladder; cosmetic application for wrinkles
- SYNONYM: OnabotulinumtoxinA
- CLASS: Acetylcholine inhibitor, Neuromuscular blocker, Ophthalmic agent, toxin
- HALF-LIFE: 3–6 months
CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:
Aminoglycosides, Anticholinergics, Fesoterodine, Tiotropium, Trospium
PREGNANCY CATEGORY: C
Distant spread of toxin effect - postmarketing reports indicate that all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing diffculties. These symptoms have been reported hours to weeks after injection.
An antitoxin is available in the event of overdose or misinjection.
DISTANT SPREAD OF TOXIN EFFECT
See full prescribing information for complete boxed warning.
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SKIN.
HAIR.
MUCOSAL.
CARDIOVASCULAR.
CENTRAL NERVOUS SYSTEM.
GASTROINTESTINAL/HEPATIC.
GENITOURINARY.
LOCAL.
NEUROMUSCULAR/SKELETAL.
OCULAR.
OTIC.
RESPIRATORY.
OTHER.
Page last updated 07/11/2020
Symbol key
Incidence 
- <1%
- 1-5%
- 5-10%
- 10-15%
- 15-20%
- 20-30%
- >30%
Seriousness
- Hospitalization possible
- Life threatening
- Fatal
Warnings in other populations
- Breast feeding
- Geriatric
- Pediatric
