onabotulinumtoxinA, Botox, Botox Cosmetic (cont.)

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Medical and Pharmacy Editor:

It also is effective for managing urinary incontinence associated with neurologic conditions such as multiple sclerosis for which it is injected into the muscular bladder wall to prevent involuntary muscular spasm that leads to incontinence (uncontrollable urination). B

Botox cosmetic is used for reducing glabellar lines (frown lines) in adults 65 years of age or younger.

SIDE EFFECTS: Side effects of onabotulinumtoxinA include:

Patients also complain of pain and tenderness at the injection site. Patients treated for blepharospasm may experience

Those treated for urinary incontinence may experience:



PREPARATIONS: Powder for Injection: 50, 100 or 200 units

STORAGE: Unopened vials or reconstituted onabotulinumtoxinA should be refrigerated at 35.6 to 46.4 F (2 to 8 C). Reconstituted toxin should be used within 24 hours.

DOSING: OnabotulinumtoxinA is giving by intramuscular injection. Dosing should be individualized (based on its purpose and the patient in whom it is being used), and the lowest effective dose should be used. OnabotulinumtoxinA is not interchangeable with other preparations of botulinum toxin.

  • Chronic Migraine: 155 units divided amongst 31 sites and injected every 12 weeks
  • Upper limb spasticity: 75-360 units divided among selected sites. No more than 50 units injected per site; may repeat when effect diminishes but no sooner than every 12 weeks.
  • Cervical dystonia: 189-300 units divided among affected muscles. No more than 50 units injected per site.
  • Axillary hyperhidrosis: 50 units per arm pit; repeat when effect diminishes.
  • Blepharospasm: Initial dose is 1.25-2.5 units. Increase if response is not adequate. There appears to be no benefit in injecting more than 5 units.
  • Strabismus: Initial dose is 1.25 to 5 units per muscle; may increase subsequent doses by up to two-fold; maximum dose for each muscle is 25 units.
  • Urinary incontinence: 200 units per treatment.
Medically Reviewed by a Doctor on 7/23/2015

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