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  Description

  Botox, or OnabotulinumtoxinA, is a substance produced by a bacteria called Clostridium botulinum. It works by blocking nerve signals to muscles, which leads to a temporary decrease in muscle movement. Doctors commonly use Botox to treat various conditions caused by overactive muscles and glands. For instance, it can smooth out facial wrinkles, reduce severe sweating in the underarms, control muscle spasms in the neck and eyes, and help with certain neurological problems.

  Fact Table
  Formula	C6760H10447N1743O2010S32
  License	US FDA
  Bioavailability	100% (local injection)
  Legal status	Prescription only (Rx)
  Chemical Name	OnabotulinumtoxinA
  Elimination half-life	Approx. 4 hours (nerve terminal)
  Dosage (Strength)	50 units, 100 units, 200 units (vials)
  Pregnancy	Consult a doctor
  Brands	Botox, Dysport, Xeomin
  Protein binding	N/A (acts locally at the neuromuscular junction)
  PubChem CID	71586874
  MedlinePlus	a619021
  ChEBI	85972
  ATC code	M03AX01
  DrugBank	DB00083
  KEGG	D04571
  Routes of administration	Intramuscular, intradermal injection

  Directions

  When using Botox for medical purposes, it's administered intramuscularly or intradermally, depending on the condition being treated. For example, to treat excessive underarm sweating (severe primary axillary hyperhidrosis), a healthcare professional may inject 50 units of Botox into the skin of each underarm, evenly distributing the dose over multiple sites. The injections are typically spaced 1-2 cm apart. The exact dosage and administration pattern may vary for other conditions like cervical dystonia (neck muscle spasms) or certain types of eye muscle problems. It's also used cosmetically to temporarily lessen the appearance of facial wrinkles.

  Ingredients

  The active ingredient in Botox is OnabotulinumtoxinA.

  Contraindications

  Individuals should avoid using this medication if any of the following apply:

  • Hypersensitivity to botulinum toxin or any formulation ingredients
  • Infection at the injection site
  • Urinary tract infection or urinary retention (specific to intradetrusor injections)

  Cautions

  • Before beginning treatment with Botox, it's important to discuss the following with your healthcare provider:
  • Your current health conditions
  • Any allergies you may have
  • All medications you are currently using
  • Whether you are pregnant or breastfeeding

  • Sometimes, the effects of Botox can spread beyond the injection site and affect other parts of the body. You might experience muscle weakness, double vision, drooping eyelids, difficulty swallowing, changes in your voice, trouble speaking, urinary incontinence, or breathing problems. These symptoms can appear hours to weeks after the injection and can be severe.
  • If you have certain neurological conditions like ALS or myasthenia gravis, you might be at a higher risk for serious side effects from Botox, including significant muscle weakness and breathing difficulties.
  • Problems with swallowing or breathing are particularly serious because they can sometimes lead to death. This risk is higher if you already have problems with swallowing or breathing before receiving Botox.
  • Botox is measured in unique units that are specific to its formulation. You cannot substitute it with other products that might seem similar because their dosing and effects could differ.
  • There is a risk of allergic reactions, which could be severe. Watch for signs like rashes, hives, swelling, or difficulty breathing, and seek medical attention if these occur.
  • Using Botox outside of its approved uses can lead to serious adverse reactions, including severe muscle weakness, difficulty swallowing, and even conditions leading to pneumonia.
  • If you're getting Botox near your eyes, like for treating eyelid spasms, there's a risk it could affect your eyesight or cause injury to your eye. Take precautions to protect your eyes.
  • If you have cervical dystonia and get treated with Botox, be cautious if you have smaller neck muscles or existing breathing issues, as the treatment might make swallowing difficult.
  • If you're treated with Botox for spasticity and have compromised lung function, monitor your breathing closely post-treatment, as it might lead to worsened respiratory conditions.
  • Botox can increase the likelihood of urinary tract infections, especially after bladder treatments. There might be a need for catheterization if you experience urinary retention.

  Side Effects

  Botox injections can commonly cause some discomfort such as localized pain, swelling, redness, or bruising at the injection site. Some people may also experience flu-like symptoms including nausea, fever, or muscle aches shortly after treatment. These side effects generally resolve quickly and are part of the body’s normal response to the injection.

  Serious reactions can occur, particularly due to the potential spread of toxin effects beyond the treatment area. Important signs to watch for include difficulty swallowing, breathing difficulties, or unusual muscle weakness, which can indicate that the toxin has affected other muscles. If you experience symptoms like severe eye pain or vision problems, heartburn, pain when swallowing, or signs of an allergic reaction such as itching or extensive rash, seek medical attention immediately.

  References

  1. Botox (Onabotulinumtoxina) Product Monograph. Madison, NJ: Allergan, Inc.; 2023.
  2. Botox (Onabotulinumtoxina) Drug Label Information. Madison, NJ: Allergan, Inc.; 2023.

  
  
  

  

  About Dr. Gerardo Sison (Page Author)

  
  Dr. Sison graduated with honors from the University of Florida. He began his career in pharmacy counseling patients in a community setting and later served in hospitals and clinics. He has also worked in medication therapy management services. Read More....

  
  

  IMPORTANT NOTE: The above information is intended to increase awareness of health information and does not suggest treatment or diagnosis. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.

  Product Code : 2297

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