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The effect of botulinum toxin products are generally potentiated by concomitant use of aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission, e.g. tubocurarine-type muscle relaxants or curare-like non-depolarising blockers. Concomitant use of aminoglycosides or spectinomycin is contraindicated. Polymyxin, tetracycline and lincomycin should be carefully used in patients injected with this product. Hence such drugs should be used with caution in patients treated with botulinum toxin.
The effects of administering different botulinum neurotoxin serotypes at the same time or within several months are unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin product before the effects of a previously administered botulinum toxin disappear.
