Dysport

Clostridium botulinum type A toxin-haemagglutinin complex

Treatment of arm symptoms associated w/ focal spasticity in conjunction w/ physiotherapy; dynamic equinus foot deformity due to spasticity in ambulant paed patient ≥2 yr w/ cerebral palsy. Treatment of spasmodic torticollis, blepharospasm, & hemifacial spasm in adults. Temporary improvement in the appearance of moderate to severe glabellar lines seen at frown in adults <65 yr.

Arm spasticity Adult 1,000 u IM distributed among 5 muscles: 300-400 u for biceps brachii, 150 u for flexor digitorum profundus, 150-250 u for flexor digitorum superficialis, 150 u for flexor carpi ulnaris, 150 u for flexor carpi radialis. Inj may be repeated approx every 16 wk or as required to maintain a response, but not more frequently than every 12 wk. Paed cerebral palsy spasticity Initially 20 u/kg IM given as a divided dose between both calf muscles. Use 10 u/kg if only 1 calf is affected. Dose may be titrated w/in 10-30 u/kg divided between both legs. Max: 30 u/kg or 1,000 u/patient whichever is lower. Inj may be repeated approx every 16 wk or as required to maintain a response, but not more frequently than every 12 wk. Spasmodic torticollis Adult w/ normal wt & no evidence of low neck muscle mass Initially 500 u IM given as a divided dose & administered to 2-3 most active neck muscles. Recommended dose range: 250-1,000 u. Max: 1,000 u. Inj may be repeated approx every 16 wk or as required to maintain a response, but not more frequently than every 12 wk. Blepharospasm & hemifacial spasm Adult & elderly Initially 40 u/eye SC medially & laterally into the junction between preseptal & orbital parts of both the upper & lower orbicularis oculi muscles of the eyes. Dose may be increased to 60, 80, or 120 u/eye. Glabellar lines Adult 50 u IM divided into 5 inj sites. Treatment interval should not be more frequent than every 3 mth.

Hypersensitivity. Presence of infection at the proposed inj site; myasthenia gravis, Eaton Lambert syndrome, amyotrophic lateral sclerosis.

Should only be used to treat a single patient, during a single session. Should not be used to treat spasticity in patients who have developed fixed contracture. Reports of side effects related to spread of toxin distant from the administration site. Caution in patients w/ subclinical or clinical evidence of marked defective neuromuscular transmission; underlying neurological disorders; dysphagia, pneumopathy, significant asthenia. As w/ any IM inj, use only where strictly necessary in patients w/ prolonged bleeding times, infection or inflammation at the proposed inj sites. Risk of Ab formation. Caution when targeted muscle shows excessive weakness or atrophy. Avoid administering different botulinum neurotoxins. May temporarily impair ability to drive or operate machinery. Should only be used during pregnancy if benefit justifies any potential risk to the foetus. Not recommended during lactation.

Generalised weakness, fatigue, flu-like syndrome, pain/bruising at inj site. Arm spasticity: Dysphagia; arm muscle weakness; accidental injury/falls. Paed cerebral palsy spasticity: Diarrhoea; leg muscle weakness, muscle pain; urinary incontinence; abnormal gait; accidental injury due to falling. Spasmodic torticollis: Dysphagia, dry mouth; muscle weakness. Headache, dizziness, facial paresis; blurred vision, reduced visual acuity; dysphonia, dyspnoea; neck pain, musculoskeletal pain, myalgia, pain in extremity, musculoskeletal stiffness. Blepharospasm & hemifacial spasm: Ptosis. Facial muscle weakness; diplopia, dry eyes, tearing; eyelid oedema. Glabellar lines: Headache; inj site reactions. Facial paresis; asthenopia, ptosis, eyelid oedema, increased lacrimation, dry eyes, muscle twitching.

Potentiated effect w/ drugs interfering directly or indirectly w/ neuromuscular function (eg, aminoglycosides, curare-like non-depolarising blockers).

Muscle Relaxants

M03AX01 - botulinum toxin ; Belongs to the class of other agents used as peripherally-acting muscle relaxants.

P₁S₁S₃