IncobotulinumtoxinA Disease Interactions

Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.

Botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, letibotulinumtoxinA, and others should not be used in the presence of infection at the proposed injection site(s) as it could lead to severe local or disseminated infection(s).

Xeomin (brand of incobotulinumtoxinA), a botulinum toxin product for the treatment of blepharospasm should be used with caution in patients at risk of developing narrow angle glaucoma. The anticholinergic effects of botulinum toxin products can reduce blinking and lead to corneal exposure, persistent epithelial defect and corneal ulceration, especially in patients with VII nerve disorders. To prevent ectropion, it is recommended that botulinum toxin products should not be injected into the medial lower eyelid area.