Botulinum Toxin, Type A

What are other names for this medicine?

Type of medicine: toxin

Generic and brand names: botulinum toxin, type A; Botox

What is this medicine used for?

This medicine is given by injections (shots) into muscles to treat cervical dystonia (stiffness and neck pain).

It is also used to treat spasms of the eyelid, uncontrollable blinking (blepharospasm), and strabismus (a condition in which the eyes do not point in the same direction).

It may be used to treat severe underarm sweating when other medicines do not work.

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• heart disease
• a nerve or muscle disorder such as ALS (Lou Gehrig's disease) or myasthenia gravis

Tell your healthcare provider if you have had any other botulinum injections in the past 4 months or if you have an infection.

Females of childbearing age: Tell your healthcare provider if you are pregnant or if you plan to become pregnant while receiving these shots. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while receiving these shots without your healthcare provider's approval.

How do I use it?

Your healthcare provider will inject the medicine into the sore or stiff muscles. The number of shots you receive depends on:

• how severe your condition is
• how many muscles are affected
• your response to the medicine.

You usually get results within 2 weeks of treatment. The benefits usually last for about 3 months. The treatment may be repeated if the stiffness and pain return.

What should I watch out for?

Treatment with this medicine may cause your body to form antibodies that may make future treatments less effective. You should receive the lowest effective dose, with at least 3 months between shots.

Injections in the muscles close to the eye may cause you to blink less. This may harm your eyes. Your healthcare provider may prescribe eyedrops, ointment, soft contact lenses, or an eye patch to protect your eyes until the medicine has worn off enough for you to be able to blink normally again.

Read the additional patient information sheet your healthcare provider will give you. Follow instructions carefully. Return to your normal activities slowly after your treatment.

This medicine may cause a dry mouth. Sucking on hard, sugar-free candy or chewing sugar-free gun may help.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat), chest pain.

Serious (report these to your healthcare provider right away): Trouble swallowing or speaking, irregular heartbeat, eye infection, blurred vision, inability to close your eye, seizures.

Other: Dry mouth; sore throat; stomach upset; neck pain; headache; pain or numbness at the injection site; dizziness; drowsiness; nausea; fever; muscle or joint pain; drooping eyelids; dry eyes; sensitivity to light; muscle weakness; sweating.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antiarrhythmics (medicines to treat irregular heartbeat) such as quinidine (quinidine sulfate, quinidine gluconate) and procainamide (Pronestyl, Procanbid)
• antibiotics such as amikacin sulfate (Amikin), gentamicin kanamycin (Kantrex), neomycin sulfate (Neo-Fradin), clindamycin (Cleocin), paromomycin (Humatin), streptomycin sulfate, or tobramycin (TOBI).
• medicine that reduces the chance of blood clots forming such as warfarin (Coumadin), heparin, dalteparin (Fragmin), and enoxaparin sodium (Lovenox)
• medicines used to treat Alzheimer's disease such as tacrine (Cognex), donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon)
• other botulinum toxins

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.