[UPDATED 08/03/2009] FDA notified healthcare professionals of changes to the established drug names for botulinum toxin Type A (Botox/Botox Cosmetic, Dysport) and botulinum toxin Type B (Myobloc) to reinforce individual potencies and prevent medication errors, and provided recommendations for healthcare professionals to consider, plus information for patients, family members, and caregivers. For more information visit the FDA website at: [Web] and [Web].
Summary of FDA-Approved Botulinum Toxin Products
Trade Name
NEW Drug Name
OLD Drug Name
Indication
Botox
OnabotulinumtoxinA
Botulinum toxin type A
Cervical dystonia, Severe primary axillary hyperhidrosis, Strabismus, Blepharospasm
Botox Cosmetic
OnabotulinumtoxinA
Botulinum toxin type A
Temporary improvement in the appearance of moderate to severe glabellar lines
Dysport
AbobotulinumtoxinA
Botulinum toxin type A
Cervical dystonia, temporary improvement in the appearance to moderate to severe glabellar lines
Myobloc
RimabotulinumtoxinB
Botulinum toxin type B
Cervical dystonia
The marketed trade names and the product formulations have not changed.
[Posted 04/30/2009] FDA notified healthcare professionals that after an ongoing safety review initiated in February 2008, the manufacturers of licensed botulinum toxin products [botulinum toxin Type A (Botox and Botox Cosmetic) and botulinum toxin Type B (Myobloc)] will be required by FDA to strengthen warnings in product labeling and add a boxed warning regarding the risk of adverse events when the effects of the toxin spread beyond the site where it was injected.
FDA will also require that manufacturers develop and implement a Risk Evaluation and Mitigation Strategy [REMS], including a communication plan to provide more information regarding the risk for distant spread of botulinum toxin effects after local injection, as well as information to explain that botulinum toxin products cannot be interchanged. The REMS would also include a Medication Guide that explains the risks to patients, their families, and caregivers. FDA is requiring the manufacturers to submit safety data after multiple administrations of the product in a specified number of children and adults with spasticity to assess the signal of serious risk regarding distant spread of toxin effects.
FDA’s evaluation of the data continues to support the recommendations made in the 2008 Early Communication. For more information visit the FDA website at: [Web], and [Web].
REMS:
FDA approved a REMS for onabotulinumtoxina (formerly botulinum toxin a) to ensure that the benefits of a drug outweigh the risks. The REMS may apply to one or more preparations of onabotulinumtoxina (formerly botulinum toxin a) and consists of the following: medication guide and communication plan. See the FDA REMS page ([Web]) or the ASHP REMS Resource Center ([Web]).
This medicine is for injection into a muscle. It is given by a health care professional in a hospital or clinic setting.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?
Visit your doctor for regular check ups.
This medicine will cause weakness in the muscle where it is injected. Tell your doctor if you feel unusually weak in other muscles. Get medical help right away if you have problems with breathing, swallowing, or talking.
This medicine contains albumin from human blood. It may be possible to pass an infection in this medicine but no cases have been reported. Talk to your doctor about the risks and benefits of this medicine.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
breathing problems
changes in vision
chest pain or tightness
eye pain, infection
fast, irregular heartbeat
fever, flu-like symptoms
numbness
speech problems
swallowing problems
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medicine?
This drug is given in a hospital or clinic and will not be stored at home.
NOTE:This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.
Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the indication prescribed.
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