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Myobloc
rimabotulinumtoxinB
Black Box Warnings .
Distant Spread of Toxin Effect
effects of all botulinum toxin products may spread beyond tx area to produce sx consistent w/ botulinum toxin; sx incl. asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties; life-threatening swallowing and breathing difficulties can occur; deaths reported; sx may occur hours to weeks after injection; risk greatest in children treated for spasticity but can occur in adults, esp. if underlying risk factors; in unapproved uses, incl. spasticity in children and adults, and in approved indications, spread of effect reported at doses comparable to tx doses for cervical dystonia, and at lower doses
Adult Dosing .
Dosage forms: INJ
cervical dystonia
- [2500-10,000 units IM divided among affected muscles x1]
- Start: 2500-5000 units IM divided among affected muscles; Info: use lower start dose in pts w/ no hx of botulinum injections; may repeat after 12-16wk
sialorrhea, chronic
- [1500-3500 units intra-glandularly divided in 4 sites x1]
- Info: inject 500-1500 units in parotid gland and 250 units in submandibular gland on both sides; may repeat no more frequently than q12wk
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.