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
- achalasia
- blepharospasm
- cervical dystonia
- facial wrinkles
- hyperhidrosis
- migraine prophylaxis
- neurogenic bladder
- overactive bladder (OAB)
- sialorrhea
- spasticity
- strabismus
- Tourette’s syndrome
- urinary incontinence
For the treatment of blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders
Side Effects
- abdominal pain
- anaphylactoid reactions
- anorexia
- antibody formation
- anxiety
- arrhythmia exacerbation
- asthenia
- back pain
- blepharedema
- constipation
- cough
- diarrhea
- diplopia
- distant spread of toxin effects
- dizziness
- drowsiness
- dysarthria
- dysphagia
- dysphonia
- dyspnea
- dysuria
- ecchymosis
- ectropion
- edema
- entropion
- erythema
- erythema multiforme
- fatigue
- fever
- headache
- hematuria
- hyperhidrosis
- hypertension
- hypertropia
- hypoesthesia
- hypotropia
- infection
- influenza
- injection site reaction
- insomnia
- keratitis
- lacrimation
- lagophthalmos
- malaise
- musculoskeletal pain
- myalgia
- myasthenia
- myocardial infarction
- nasal congestion
- nausea
- ocular hemorrhage
- ocular hypertension
- ocular infection
- ocular irritation
- paresis
- paresthesias
- pharyngitis
- photophobia
- pruritus
- psoriaform rash
- ptosis
- rash
- respiratory arrest
- rhinitis
- rhinorrhea
- seizures
- serum sickness
- syncope
- tinnitus
- urinary retention
- urticaria
- vertigo
- visual impairment
- weakness
- xerophthalmia
- 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