Abobotulinumtoxina (Intramuscular)

Abobotulinumtoxina is administered by healthcare practitioners at inpatient and outpatient facilities. It is appropriate for all age groups depending on the medical conditions.

Overview

Abobotulinumtoxina is a generic name for Dysport. It is also known as botulinum toxin type A. The substances that comprise Abobotulinumtoxina include bacteria that causes botulum, milk protein, and human blood. The medication blocks the nerve activity in the muscles which contributes to the temporary reduction in the muscle activity.

Conditions Treated:

  • Cervical dystonia
  • Muscle spasms in the upper and lower limbs
  • Deep lines between eyebrows
  • Facial wrinkles
  • Eyelid twitch
  • Increased production of saliva
  • Cerebral palsy-associated limb spasticity
  • Excessive sweating in the armpits
  • Headaches

In addition, the following are the conditions not listed on the drug's label; however, the drug is shown to be effective in treating them:

  • Anal fissures (only if the preferred therapy does not work)
  • Acquired nystagmus (only for certain patients who experience contraindications with other therapies)
  • Hand dystonia (shown to be effective and safe although more tests are needed to confirm the drug's effectiveness)
  • Sialorrhea (demonstrates some benefits in controlled trials for patients with neurological conditions although more testing is needed to confirm the treatment's effectiveness)

Type of Medicine:

  • Injectable powder

Side Effects:

There are numerous side effects that come with Abobotulinumtoxina, some more severe than others. They can occur within hours or even weeks after the shot was given. While everyone is at risk for side effects, the two groups that are the most vulnerable are children with muscle problems and the elderly who is the most likely to exhibit eye-related side effects. The side effects that can occur include hives, difficulty breathing, and the swelling of the face, lips, tongue, or throat. These are the usual symptoms of allergic reactions. The medication also causes drooping eyelids, vision problems, loss of bladder control, and the pain or the burning during urination. The list of the side effects continues with seizures, voice changes, vomiting, diarrhea, loss of appetite, shivering, stiff muscles, stuffy or runny nose, sweating, tightness in the chest, trouble sleeping, and the unusual tiredness or weakness.

Some of these side effects may disappear as your body becomes accumulated to the injection. In addition, your provider will provide additional treatments aimed specifically to cure the side effects. This is not the complete list of the side effects associated with the drug. You should contact your provider to obtain the complete list. There is also a possibility that you may experience a side effect that is not known to occur as a result of taking Abobotulinumtoxina. It is important that when you start taking the injection, you should observe your body's reactions and if they occur, document them and inform your doctor.

Dosage

The dosage of Abobotulinumtoxina depends on the muscles, the conditions being treated, and the number of muscles if applicable. For the usual adult dose for cervical dystonia, the dosage is 500 units IM as a dividing dose. The dosage for the glabellar lines is 300 units. The following is the dose that the adults should receive for the muscles listed below:

  • Sternocleidomastoid: 125 units
  • Splenius capitis: 200 units
  • Trapezius: 102.6 units
  • Levator scapulae: 105.3 units
  • Semispinalis capitis: 131.6 units
  • Longissimus: 150 units

For the spasticity, adults should receive the following dosage amount that is equivalent to 1 to 2 injections per muscle:

Upper limbs:

  • Brachialis: 200 to 400 units
  • Brachioradialis: 100 to 200 units
  • Biceps brachii: 200 to 400 units
  • Flexor carpi radialis: 100 to 200 units
  • Flexor carpi ulnaris: 100 to 200 units
  • Flexor digitorum profundus: 100 to 200 units
  • Flexor digitorum superficialis: 100 to 200 units
  • Pronator teres: 100 to 200 units

Lower limbs:

  • Flexor digitorum longus: 130 to 200 units
  • Flexor halluces longus: 70 to 200 units
  • Gastrocnemius, medial head: 100 to 150 units
  • Gastrocnemius, lateral head: 100 to 150 units
  • Soleus: 330 to 500 units
  • Tibialis posterior: 200 to 300 units

Geriatric patients can receive the same amount of dosage as younger adults for cervical dystonia and limb spasticity; however, it is not recommended that they should receive any dosage for glabellar lines. Pediatric patients should take anywhere from 10 to 15 units per limb per treatment session. Healthcare providers must take the patient's age, health history, and the medical conditions into account when prescribing certain dosage.

Drug and Medical Interactions

When taking Abobotulinumtoxina, you must keep in mind the possibility that this medication interacts with certain drugs and it can produce adverse effects as a result. Certain antibiotics, anticoagulants, Alzheimer disease drugs such as tacrine and galantamine, Myasthenia gravis drugs like ambenonium, and quinidine are just a few of the drugs known to interact with Abobotulinumtoxina. It is best to keep a list of all the medications that you're taking in addition to Abobotulinumtoxina and discuss them with your doctor and pharmacist. By discussing the medication list, both your doctor and your pharmacist become aware of your medications and decide which medication you can take along with Abobotulinumtoxina without the dangerous adverse reactions or side effects.

Even though you should take precautions to protect yourself against negative drug interactions, you should not change any dosage of the current medicines you're taking until you obtain approval from your provider.

It is also important to note that drug interactions are not limited to prescription drugs only. It also includes OTC drugs, vitamins, and natural and herbal remedy medicine. Therefore, you should notify your provider of all types of drugs that you take before receiving the Abobotulinumtoxina injection.

In addition to the presence of other drugs, your provider should also be aware of other medical problems that you have. Taking Abobotulinumtoxina while suffering from the following disorders may result in adverse effects:

  • Lou Gehrig's disease
  • Dermatochalasis
  • Lambert-Eaton syndrome
  • Motor neuropathy
  • Myasthenia gravis
  • Sebaceous skin

If you have a history of a surgery performed on your face, you need to notify your provider before receiving the injection since it may increase the risk for more serious side effects.

Warnings

Serious muscle reactions occur within hours to weeks after receiving the injection. Avoid driving and using machinery when you can't see well and are not feeling well. You should also wait until you are familiar with the drug's effects before you drive or operate machines after taking it. Part of the drug is made from donated human blood which is capable of transmitting certain diseases. However, the risk of contracting the diseases is low because human donors are required to undergo testing that detects the diseases and the manufacturing of the drug undergoes testing to prevent such a risk.

Due to the interactions mentioned above, you should not take other medications unless you discuss with your doctor and get approval. That includes prescription, OTC drugs, and natural herbal remedies. There is a possibility that you can overdose on Abobotulinumtoxina when you receive too much dosage. If you overdose, you should contact the local poison center or in case of difficulty breathing call 911.

It is important to note that Abobotulinumtoxina can only be effective at treating wrinkles in certain circumstances. For example, the injection either will not work or can cause harmful effects when a patient suffers from drooping eyelids, excess skin on eyelids, and deeply scarred skin.

The testing for the effects of Abobotulinumtoxina has not been performed on certain groups which are pregnant women, children, and senior citizens. Pediatric patients are only allowed to receive the drug to treat cervical dystonia or the upper limbs spasm; pediatricians should not prescribe the drug to treat the glabellar lines. For the geriatric patients, providers should use caution when using Abobotulinumtoxina to treat the glabellar lines because they are most likely to experience the eye-related side effects as a result of the injections.

For pregnant patients, there are no known data established that would prevent pregnant women from taking Abobotulinumtoxina. There was a study where a mother breastfeeds her infant after receiving the drug. No botulinum toxin was detectable in the milk or the infant. the risks that infants face when consuming low dosage is low and no adverse effects occur after the breastfeeding occurs.

While the drug has not been tested on these groups, it has been tested on animals and they do experience the effects of the drug. The effects are the adverse effects on the fetus. So far, only the animal subjects are being tested completely whereas humans are not. In other words, healthcare professionals should use caution and monitor the effects of the Abobotulinumtoxina treatment in these patients, especially when there are no scientific studies that prove whether or not this treatment is safe for these vulnerable groups of patients.

Storage

Abobotulinumtoxina is stored by licensed practitioners at a hospital or a clinic; it should not be stored at home by patients. The facility staff stores the undiluted vials of the drug in a refrigerator at 36-46 degrees Fahrenheit. It must be shielded from light. It should be used within 24 hours and it is a single-use; as a result, you should not refreeze it.

Summary

The effectiveness of the Abobotulinumtoxina treatment depends on the medical conditions. For example, the peak effect is 2-4 weeks when treating the cervical dystonia and one week for the upper limb spasticity. the duration of the medicine's effectiveness also depends on the conditions that it treats. For the cervical dystonia and the glabellar lines, it will last about four months; for the upper and the lower limb spasticities it's about five months. While Abobotulinumtoxina is known for treating certain muscle spasms and facial wrinkles, it is possible that it treats other medical conditions not listed on the drug label. It is okay to take Abobotulinumtoxina for these conditions as long as it is approved by the providers and that they monitor the patient's health and well-being throughout the course of the treatment.

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Last Reviewed:
December 10, 2017
Last Updated:
April 04, 2018
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