RimabotulinumtoxinB Disease Interactions

The use of rimabotulinumtoxinB is contraindicated for use in patients with infection at the proposed injection site.

Treatment with rimabotulinumtoxinB can result in swallowing or breathing difficulties. Patients with preexisting-existing swallowing or breathing difficulties may be more susceptible to these complications. Deaths as a complication of severe dysphagia have been reported after treatment with botulinum toxin. Dysphagia may persist for several months and require use of a feeding tube to maintain adequate nutrition and hydration. Treatment of cervical dystonia with botulinum toxins may weaken neck muscles that serve as accessory muscles of ventilation, which may result in a critical loss of breathing capacity in patients with respiratory disorders who may have become dependent upon these accessory muscles. There have been postmarketing reports of serious breathing difficulties, including respiratory failure, in cervical dystonia patients. Patients treated with rimabotulinumtoxinB may require immediate medical attention should they develop problems with swallowing, speech or respiratory disorders. These reactions can occur within hours to weeks after injection. Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junctional disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) should be monitored particularly closely when given rimabotulinumtoxinB, as they may be at increased risk of clinically significant effects including severe dysphagia and respiratory compromise from typical doses of rimabotulinumtoxinB.