onabotulinumtoxinA, Botox, Botox Cosmetic (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

It is injected into the muscles that control the eyeball for treating strabismus (misaligned or lazy eyes) and the muscles of the eyelid for treating blepharospasm (uncontrollable blinking) associated with a condition called dystonia.

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.

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.

DRUG INTERACTIONS: Administration of onabotulinumtoxinA with other agents (for example, aminoglycosides, curare) that affect neuromuscular function may increase the effect of onabotulinumtoxinA. Use of muscle relaxants may increase the occurrence of weakness. Use of drugs that block acetylcholine may increase some effects of onabotulinumtoxinA.

PREGNANCY: There are no adequate studies of onabotulinumtoxinA in pregnant women.

NURSING MOTHERS: OnabotulinumtoxinA has not been evaluated in nursing mothers



Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Pill Finder Tool

Need help identifying pills and medications?
Use the pill identifier tool on RxList.


Back to Medications Index