IncobotulinumtoxinA Side Effects

It is possible that some side effects of incobotulinumtoxinA may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to incobotulinumtoxinA: intramuscular powder for solution

Along with its needed effects, incobotulinumtoxinA may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking incobotulinumtoxinA:

More common—for cervical dystonia
  • Difficulty with swallowing
  • muscle or bone pain
  • muscle weakness
  • pain in the neck
More common—for blepharospasm
  • Dry eyes
Rare—for glabellar lines
  • Itching, pain, redness, or swelling at the injection site
  • pain in the face
  • swelling of the eyelids
Incidence not known
  • Changes in patterns and rhythms of speech
  • fast heartbeat
  • fever
  • hives
  • hoarseness
  • irritation
  • itching
  • joint pain, stiffness, or swelling
  • muscle spasm
  • pain at the injection site
  • rash
  • redness of the skin
  • shortness of breath
  • slurred speech
  • swelling of the eyes or eyelids
  • swelling of the face, lips, hands, or feet
  • tightness in the chest
  • trouble with speaking
  • troubled breathing or swallowing
  • wheezing

Some side effects of incobotulinumtoxinA may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common—for cervical dystonia
  • Chills
  • cough
  • lower back or side pain
  • painful or difficult urination
More common—for blepharospasm
  • Blurred vision
  • diarrhea
  • drooping upper eyelids
  • dry mouth
  • headache
Less common—for blepharospasm
  • Difficult or labored breathing
  • muscle aches
  • sneezing
  • sore throat
  • stuffy or runny nose
  • unusual tiredness or weakness
Rare—for glabellar lines
  • Drooping of the eyelids
  • increased blinking
  • twitching of the eyelids
Incidence not known
  • Difficulty with moving
  • joint pain
  • muscle aching or cramping
  • muscle pains or stiffness
  • nausea
  • painful blisters on the trunk of the body
  • swollen joints

For Healthcare Professionals

Applies to incobotulinumtoxinA: intramuscular powder for injection


Musculoskeletal side effects have included neck pain (7% to 15%), muscular weakness (7% to 11%), musculoskeletal pain (4% to 7%), and muscle spasm.


Gastrointestinal side effects have included dysphagia (13%), dry mouth (16%), diarrhea (8%), and nausea.

Nervous system

Nervous system side effects have included headache (7%).


Local side effects have included injection site pain (9%), injection site reaction, allergic dermatitis, localized allergic reactions like swelling, edema, erythema, pruritus or rash, and herpes zoster.


Ocular side effects have included eyelid ptosis (19%), dry eye (16%), visual impairment (12%), eye swelling, and eyelid edema.


Respiratory side effects have included nasopharyngitis (5%), respiratory tract infection (5%), and dyspnea (5%).


Immunologic side effects have included infections and infestations (13% to 14%). Postmarketing reports have included flu-like symptoms.

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