IncobotulinumtoxinA Brand Name– Xeomin
What is IncobotulinumtoxinA
IncobotulinumtoxinA is a parenteral acetylcholine release inhibitor and neuromuscular blocking agent indicated for the treatment or improvement of adult patients with blepharospasm, cervical dystonia, upper limb spasticity, severe glabellar lines, or chronic sialorrhea. Unlike other marketed botulinum toxins, the final incobotulinumtoxinA formulation is a purified product that does not contain accessory protein complexes, which is expected to decrease the immunogenic potential.
In noninferiority trials, no statistically significant differences in time to onset, paralytic effect, or response rates were noted between incobotulinumtoxinA and onabotulinumtoxinA treated muscles.
Like other botulinum toxins, botulinum toxin effects may be observed beyond the site of local injection, in some cases.
Swallowing and breathing difficulties can be life-threatening; deaths related to the spread of toxins have been reported.
Indications
- blepharospasm
- cervical dystonia
- facial wrinkles
- sialorrhea
- spasticity
Side Effects
- anaphylactoid reactions
- antibody formation
- arthralgia
- asthenia
- back pain
- blepharedema
- blepharospasm
- blurred vision
- corneal erosion
- diarrhea
- diplopia
- distant spread of toxin effects
- dysarthria
- dysphagia
- dysphonia
- dyspnea
- ecchymosis
- ectropion
- edema
- erythema
- headache
- hematoma
- hypertension
- infection
- influenza
- injection site reaction
- muscle cramps
- musculoskeletal pain
- myalgia
- nausea
- paresis
- pharyngitis
- photophobia
- pruritus
- ptosis
- rash
- seizures
- serum sickness
- urinary incontinence
- urticaria
- visual impairment
- weakness
- xerophthalmia
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- albumin hypersensitivity
- amyotrophic lateral sclerosis (ALS)
- breast-feeding
- children
- closed-angle glaucoma
- distant spread of toxin effects
- driving or operating machinery
- dysphagia
- infants
- infection
- myasthenia gravis
- neonates
- neuromuscular disease
- pregnancy
- requires an experienced clinician
- respiratory insufficiency
- sucrose hypersensitivity
- surgery
- viral infection
Interactions
- Amikacin
- Anticholinergics
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Atracurium
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Baclofen
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Capreomycin
- Capsaicin; Metaxalone
- Carisoprodol
- Chlordiazepoxide; Clidinium
- Chlorzoxazone
- Cisatracurium
- Cyclobenzaprine
- Dantrolene
- Dicyclomine
- Doxacurium
- Flavoxate
- Gentamicin
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Homatropine; Hydrocodone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Indacaterol; Glycopyrrolate
- Kanamycin
- Mepenzolate
- Metaxalone
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methscopolamine
- Mivacurium
- Neomycin
- Neuromuscular blockers
- Orphenadrine
- Oxybutynin
- Pancuronium
- Paromomycin
- Polymyxins
- Propantheline
- Rapacuronium
- Rocuronium
- Scopolamine
- Skeletal Muscle Relaxants
- Solifenacin
- Streptomycin
- Succinylcholine
- Tapentadol
- Tobramycin
- Trihexyphenidyl
- Trospium
- Tubocurarine
- Vecuronium
