Drug reference

Botulinum toxin type A

Neuromuscular Blocker · Neuromuscular Agent

Neuromuscular BlockerNeuromuscular Agent

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

AmikacinSevereDatabaseDDInter
AtracuriumSevereDatabaseDDInter
CisatracuriumSevereDatabaseDDInter
ColistimethateSevereDatabaseDDInter

Mechanism

Botulinum toxin type A acts on the presynaptic nerve terminal to block the release of acetylcholine (ACh) from cholinergic fibers. This interference with ACh release prevents muscle contraction, leading to localized muscle paralysis or reduced glandular secretion. Death from respiratory paralysis can occur unless patients with respiratory failure receive artificial ventilation.

Indications

Hand and wrist disability due to upper limb spasticity associated with stroke (specialist use only)Foot and ankle disability due to lower limb spasticity associated with stroke (specialist use only)Blepharospasm (specialist use only)Hemifacial spasm (specialist use only)Spasmodic torticollis (specialist use only)Severe hyperhidrosis of the axillae (specialist use only)Prophylaxis of headaches in chronic migraine (specialist use only)Temporary improvement of moderate to severe upper facial lines in adults under 65 years (specialist use only)Management of bladder dysfunctions (specialist use only)Chronic sialorrhoea due to neurological disorders (specialist use only)Strabismus (off-label)Muscle dystonias (off-label)Palsy (off-label)Cosmetic erasure of facial lines and wrinkles (off-label)Torsion dystonia and other involuntary movements (after acquired non-progressive brain injury if rapid-onset spasticity causes postural or functional difficulties)Excessive drooling of saliva (unlicensed indication)strabismusblepharospasm associated with dystoniafacial wrinkles (glabellar lines)bladder dysfunction and urinary incontinencespasticityaxillary hyperhidrosisspasmodic torticollis (cervical dystonia)chronic migraine

Dosing

Adult: Consult product literature. Administered by subcutaneous injection, or by intradermal injection, or by intramuscular injection, or by local infiltration.