Incobotulinumtoxina (Intramuscular)

Overview

Incobotulinumtoxina is a medicine that is approved for treating cervical dystonia (severe neck spasms) and blepharospasm (severe eyelid spasms). It also helps treat upper limb spasticity resulting from stroke and temporarily removes facial wrinkles.

Incobotulinumtoxina is a solution made from a neurotoxin known as botulinum toxin. It interferes with the working of nerves in your muscles, making them weak and paralyzed. Healthcare professionals find this helpful in alleviating problems caused by unnecessary muscle contractions.

Incobotulinumtoxina can make your symptoms improve within four to seven days. Its effects usually last for three to four months.

Incobotulinumtoxina is only available with a prescription under the brand name Xeomin. It comes in injectable form, so you'll likely receive it at a hospital or doctor's clinic. Only a trained healthcare professional can give you an injection of Incobotulinumtoxina.

Conditions Treated

  • Eyelid twitch
  • Twisting neck spasms
  • Deep lines between the eyebrows
  • Upper/lower limb muscle spasms

Type Of Medicine

  • Neurotoxin

Side Effects

Just like any medication, Incobotulinumtoxina may bring on side effects. Not everybody who receives Incobotulinumtoxina will have problems, though. In fact, the majority of people tolerate it rather well. In most cases, the effects that do occur are mild and either don't require treatment or are easily treated by you or your healthcare professional.

This section covers a number of, though not all, the potential Incobotulinumtoxina side effects. For a more comprehensive list, please consult your healthcare professional.

Common Incobotulinumtoxina side effects

Incobotulinumtoxina has been extensively studied in various clinical trials. In those studies, the effects that developed in a group of people given Incobotulinumtoxina were recorded and compared with those that developed in a similar group given a placebo (another injection that didn't have any active ingredients). Consequently, it became possible to notice which effects happened, how frequently they happened and how the experimental group contrasted with the group receiving the placebo.

In studies of Incobotulinumtoxina for cosmetic purposes (to improve the look of lines between eyebrows), a headache was the only effect, affecting 5.4% of people who were given Incobotulinumtoxina, compared to 2.2% of people who were given the placebo. The rest of the side effects affected less than 1% of people.

In studies of Incobotulinumtoxina for treatment of cervical dystonia (a problem involving head and neck muscle spasms), the most common effects were as follows:

  • Any infection occurred in 13% of people
  • Neck pain occurred in 15% of people
  • Difficulty with swallowing occurred in 18% of people
  • Muscle pain occurred in 4% of people
  • Muscle weakness occurred in 11% of people
  • Pain at injection site occurred in 4% of people

In studies of Incobotulinumtoxina for eyelid spasms (blepharospasm), the most common effects included:

  • Diarrhea occurred in 8% of people
  • Shortness of breath occurred in 5% of people
  • Headache occurred in 7% of people
  • Vision problems occurred in 12% of people
  • Dry eyes occurred in 16% of people
  • Dry mouth occurred in 16% of people
  • Droopy eyelids occurred in 19% of people
  • Any kind of infection occurred in 20% of people

Some Incobotulinumtoxina side effects are potentially severe and should be immediately reported to your healthcare professional. These include but aren't limited to:

Signs of a toxin effect spreading (a condition called botulism), including:

  • Difficulty with swallowing
  • Difficulty with breathing
  • Speech problems
  • Loss of control of bladder
  • Voice changes
  • Droopy eyelids
  • Blurred vision
  • Double vision
  • Muscle weakness over the whole body

Signs of an allergy, including:

  • Itching
  • Hives
  • An unexplained rash
  • Swelling of the throat or mouth
  • Wheezing
  • Difficulty with breathing

You may experience none or some of the Incobotulinumtoxina side effects mentioned in this section. Unfortunately, your healthcare professional can't tell in advance if you'll have issues with a medication that you've never used.

Therefore, be sure to notify your healthcare professional if you experience any effects while receiving Incobotulinumtoxina or if something doesn't seem right. Although it may have nothing to do with Incobotulinumtoxina, your healthcare professional should be able to not only diagnose the problem, but treat it as well.

Dosage

Incobotulinumtoxina is injected into one of your muscles. A nurse, doctor or other healthcare professional will give the injection. There should be intervals of at least three months between injections of Incobotulinumtoxina. Depending on the problem being treated, you may receive injections in more than one part of your body at a time.

While receiving Incobotulinumtoxina injections for conditions of the eye muscle, you may need special contact lenses, an ointment, eye drops or other item to protect your eye's surface. Follow your healthcare professional's instructions.

It can take up to a week after injection before symptoms of neck muscle spasms start to improve, but Incobotulinumtoxina produces temporary effects. Your symptoms may come back altogether within three months of receiving an injection. After subsequent injections, it may not be long before your symptoms come back, especially if you develop antibodies to Incobotulinumtoxina.

Do not seek Incobotulinumtoxina injections from two or more healthcare professionals at the same time. If you change healthcare professionals, make sure to let your new healthcare professional know how long it's been since you received your last Incobotulinumtoxina injection.

Using Incobotulinumtoxina more often than instructed won't increase its effectiveness and may cause serious side effects. If you notice symptoms of an Incobotulinumtoxina overdose, call your local poison control agency at 1-800-222-1222 or seek emergency medical assistance. Symptoms of an overdose may not occur straight away, but may include trouble with swallowing, muscle weakness, lack of movement in any body part, or shallow or weak breathing.

Since Incobotulinumtoxina is given at broadly spaced intervals and produces a temporary effect, missing a single dose is unlikely to be harmful.

Interactions

Incobotulinumtoxina may impair your perception of depth or vision. Be cautious if you drive a car or carry out any activity that requires clear vision.

Don't go back to your usual physical activities too soon after receiving an Incobotulinumtoxina injection.

Other medicines like allergy or cold medicines, sleeping pills, bronchodilators, muscle relaxers, urinary or bladder medicines and medicines for irritable bowel syndrome may increase some Incobotulinumtoxina side effects. Tell your healthcare professional if you regularly take any of these medicines.

Tell your healthcare professionals about all medications you take and those you stop or begin taking during your Incobotulinumtoxina treatment, especially a blood thinner like Jantoven, Coumadin, Warfarin or an injected antibiotic like Gentamicin, Amikacin, Kanamycin, Paromomycin, Neomycin, Tobramycin or Streptomycin.

This list of Incobotulinumtoxina drug interactions isn't complete. Other medications can interact with Incobotulinumtoxina, such as over the counter and prescription medicines, herbal products and vitamin supplements. For more information about Incobotulinumtoxina drug interactions, ask your doctor and pharmacist.

Warnings

Before receiving an injection of Incobotulinumtoxina:

Tell your pharmacist and doctor if you have allergies to Incobotulinumtoxina, OnabotulinumtoxinA (Botox), AbobotulinumtoxinA (Dysport), RimabotulinumtoxinB (Myobloc), any of Incobotulinumtoxina's ingredients, or any other medications. Find out the list of ingredients from your pharmacist or check the patient information leaflet or Medication Guide.

Tell your pharmacist and doctor what other nonprescription and prescription medicines, nutritional supplements, herbal products and vitamins you're using or plan to use. Make sure to name any of these:

  • Certain antibiotics like Amikacin, Colistimethate (Coly-Mycin), Clindamycin (Cleocin), Lincomycin (Lincocin), Kanamycin, Gentamicin, Tobramycin (Tobi), Streptomycin, Neomycin (Neo-Rx, Neo-Fradin), and Polymyxin
  • Cholinesterase inhibitors like Donepezil (Aricept), Ambenonium (Mytelase), Galantamine (Razadyne), Tacrine (Cognex), Neostigmine (Prostigmin), Physostigmine, Pyridostigmine (Regonol, Mestinon), Rivastigmine (Exelon), and Magnesium Sulfate
  • Anticoagulants (blood thinners)
  • Medications for colds, allergies, or sleep
  • Qunidine
  • Muscle relaxants

Also inform your healthcare professional if you've had injections of any Incobotulinumtoxina product in the last four months. Your healthcare professional may need to adjust your doses of medications or carefully monitor you for side effects.

Tell your physician if you've got swelling or other infection symptoms in the part where you'll receive the Incobotulinumtoxina injection. Your physician won't inject Incobotulinumtoxina into an infected part.

Tell your healthcare professional if you've ever experienced any side effect after using any Incobotulinumtoxina product or after having a face or eye operation. Also tell them if you've ever experienced bleeding problems.

Tell your physician if you're pregnant, want to get pregnant or are nursing an infant. If you get pregnant while being treated with Incobotulinumtoxina, call your physician.

You need to know that Incobotulinumtoxina may cause impaired vision, or muscle weakness and loss of strength all over your body. If you suffer any of these effects, don't drive, operate any machine or carry out any other hazardous activity. Avoid driving or carrying out other tasks or activities that require you to have clear vision or be alert until you understand how Incobotulinumtoxina affects you.

If you're being treated with Incobotulinumtoxina for a condition that restricted your activities, speak to your healthcare professional about increasing your tasks and activities after treatment. Your physician will probably ask you to gradually increase your activities as you get used to the effects associated with your treatment.

Don't switch between various versions of Incobotulinumtoxina without discussing this with your doctor first.

Since human plasma is used to make Incobotulinumtoxina, the medication may contain viruses that may result in disease. Incobotulinumtoxina is screened, examined and treated to reduce its chances of carrying an infection. Discuss this with your doctor.

Storage

Incobotulinumtoxina should be kept in the freezer or refrigerator at room temperature. Incobotulinumtoxina is kept at your healthcare professional's office in a dry powder form that must be mixed with saline. After mixing the powder, keep it in the freezer or refrigerator and use it within 24 hours.

If you want to store Incobotulinumtoxina at home, consult your pharmacist, nurse or doctor about how to keep it.

Summary

This medication contains botulinum toxin, which may spread to other areas of the body beyond the injection site. This may cause severe life-threatening symptoms in some patients receiving injections of Incobotulinumtoxina, even for cosmetic reasons.

Call your healthcare professional immediately if you have drooping eyelids, a hoarse voice, severe muscle weakness, vision problems, loss of control of bladder or trouble breathing, swallowing or talking. Some of these side effects may happen up to weeks after you receive an Incobotulinumtoxina injection.

Don't seek Incobotulinumtoxina injections from two or more healthcare professionals at the same time. If you change healthcare professionals, make sure to notify your new healthcare specialist how long it's been since you last received an Incobotulinumtoxina injection.

Using Incobotulinumtoxina more often than instructed won't increase its effectiveness and may lead to serious side effects.

You shouldn't receive Incobotulinumtoxina if you're allergic to it, if you've got an infection, muscle weakness or swelling in the part where the drug will be injected.

Before receiving an Incobotulinumtoxina injection, let your physician know if you've got Lou Gehrig's disease, Lambert-Eaton syndrome, myasthenia gravis, trouble swallowing, a breathing disorder, facial muscle weakness, change in the look of your face, bleeding problems, seizures or heart disease. Also, let them know if you'll have or have had surgery, or if you've ever been given other injections similar to Incobotulinumtoxina, such as Myobloc, Botox or Dysport.

The effects of an Incobotulinumtoxina injection are short-lived. Your symptoms can come back altogether within three months after receiving an injection. After frequent injections, your symptoms may return after a very short time, especially if you develop antibodies to Incobotulinumtoxina.

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