OnabotulinumtoxinA

OnabotulinumtoxinA Brand Name– Botox | Botox Cosmetic

What is OnabotulinumtoxinA

OnabotulinumtoxinA (formerly known as botulinum toxin type A) is an intramuscular toxin produced from fermentation of Clostridium botulinum type A. It is one of 7 toxic serotypes of botulinum (A through G) that have been purified.

Two of the serotypes are available commercially in the United States, type A and type B; both are used to reduce local muscle activity, albeit temporarily.

Type A toxins are more potent and longer acting than type B; approximately 7.5 to 10 units of type A is roughly equivalent in the degree of muscle paralysis to 320 to 480 units of type B.

Indications

  1. achalasia
  2. blepharospasm
  3. cervical dystonia
  4. facial wrinkles
  5. hyperhidrosis
  6. migraine prophylaxis
  7. neurogenic bladder
  8. overactive bladder (OAB)
  9. sialorrhea
  10. spasticity
  11. strabismus
  12. Tourette’s syndrome
  13. urinary incontinence

For the treatment of blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. anorexia
  4. antibody formation
  5. anxiety
  6. arrhythmia exacerbation
  7. asthenia
  8. back pain
  9. blepharedema
  10. constipation
  11. cough
  12. diarrhea
  13. diplopia
  14. distant spread of toxin effects
  15. dizziness
  16. drowsiness
  17. dysarthria
  18. dysphagia
  19. dysphonia
  20. dyspnea
  21. dysuria
  22. ecchymosis
  23. ectropion
  24. edema
  25. entropion
  26. erythema
  27. erythema multiforme
  28. fatigue
  29. fever
  30. headache
  31. hematuria
  32. hyperhidrosis
  33. hypertension
  34. hypertropia
  35. hypoesthesia
  36. hypotropia
  37. infection
  38. influenza
  39. injection site reaction
  40. insomnia
  41. keratitis
  42. lacrimation
  43. lagophthalmos
  44. malaise
  45. musculoskeletal pain
  46. myalgia
  47. myasthenia
  48. myocardial infarction
  49. nasal congestion
  50. nausea
  51. ocular hemorrhage
  52. ocular hypertension
  53. ocular infection
  54. ocular irritation
  55. paresis
  56. paresthesias
  57. pharyngitis
  58. photophobia
  59. pruritus
  60. psoriaform rash
  61. ptosis
  62. rash
  63. respiratory arrest
  64. rhinitis
  65. rhinorrhea
  66. seizures
  67. serum sickness
  68. syncope
  69. tinnitus
  70. urinary retention
  71. urticaria
  72. vertigo
  73. visual impairment
  74. weakness
  75. xerophthalmia
  76. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • albumin hypersensitivity
  • amyotrophic lateral sclerosis (ALS)
  • anticoagulant therapy
  • autonomic neuropathy
  • breast-feeding
  • cardiac disease
  • children
  • distant spread of toxin effects
  • driving or operating machinery
  • dysphagia
  • geriatric
  • hyperthyroidism
  • infection
  • intravenous administration
  • myasthenia gravis
  • myopathy
  • neuromuscular disease
  • ocular disease
  • pregnancy
  • requires an experienced clinician
  • respiratory insufficiency
  • surgery
  • thyroid disease
  • urinary retention
  • urinary tract infection (UTI)
  • viral infection
  • visual disturbance

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
  • Bacitracin
  • 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
  • RimabotulinumtoxinB
  • Rocuronium
  • Scopolamine
  • Skeletal Muscle Relaxants
  • Solifenacin
  • Streptomycin
  • Succinylcholine
  • Tapentadol
  • Tobramycin
  • Trihexyphenidyl
  • Trospium
  • Tubocurarine
  • Vecuronium
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