Drug Index

Onabotulinumtoxin A

 
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Mechanism :

It is a neurotoxin which affects presynaptic membrane of the neuromuscular junction where it prevents calcium-dependent release of acetylcholine and produces a state of denervation.


Indication :

• Axillary hyperhidrosis

• Chronic migraine

• Glabellar lines

• Forehead lines

• Upper and lower limb spasticity

• Overactive bladder

• Strabismus and blepharospasm associated with dystonia.

• Off-label: Achalasia; Anal fissures; Raynaud phenomenon, severe, refractory to initial conventional therapy; Sialorrhea, Tardive dyskinesia.


Contraindications :

Hypersensitivity to any botulinum toxin preparation or any component of the formulation; infection at the proposed injection site


Dosing :

Benign essential blepharospasm, VII nerve disorders, cervical dystonia:

>12 years: 1.25-2.5 units in any 1 muscle.

Horizontal strabismus of 20 prism dioptres to 50 prism dioptres:

>12 years: 2.5-5 units in any 1 muscle. The maximum recommended dose as a single injection for any 1 muscle is 25 units.

The lowest recommended dose should be used when initiating treatment. Each treatment lasts approximately 3 months, after which the procedure can be repeated. Maximum cumulative dose of 6 units/kg, up to 200 units over 3 months.

Upper and lower limb spasticity in children with cerebral palsy:

2 to 18 years: Start with ≤50 units/site. The lowest recommended dose should be used when initiating treatment. Each treatment lasts approximately 3 months, after which the procedure can be repeated. Maximum cumulative dose of 6 units/kg, up to 200 units over 3 months.

Urinary incontinence due to detrusor overactivity associated with a neurologic condition:

1-16 years: 12 units/kg (Maximum 300 units) injected into the detrusor muscle using 30-50 injections, sparing the trigone.


Adverse Effect :

Musculoskeletal and connective tissue disorders, dysphagia, muscular weakness, dry eye, xerostomia, nervous system disorders, seizures, diarrhea, headache, dyspnea.


Interaction :

Abobotulinumtoxin A: Onabotulinumtoxin A may enhance the adverse neuromuscular effect of Abobotulinumtoxin A.
Aminoglycosides: May enhance the neuromuscular-blocking effect of Onabotulinumtoxin A.

Anticholinergic Agents: May enhance the anticholinergic effect of Onabotulinumtoxin A.
Neuromuscular-Blocking Agents: May enhance the neuromuscular-blocking effect of Onabotulinumtoxin A.


07/14/2019 20:02:02 Onabotulinumtoxin A
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