Skip to Content

IncobotulinumtoxinA Side Effects

In Summary

Commonly reported side effects of incobotulinumtoxinA include: asthenia, blepharoptosis, dysphagia, myasthenia, neck pain, visual disturbance, and xerostomia. Other side effects include: dyspnea, diarrhea, musculoskeletal pain, and pain at injection site. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to incobotulinumtoxinA: intramuscular powder for solution

In addition to its needed effects, some unwanted effects may be caused by incobotulinumtoxinA. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking incobotulinumtoxinA, check with your doctor or nurse immediately:

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, itching, or rash
  • hoarseness
  • irritation
  • joint pain, stiffness, or swelling
  • muscle spasm
  • pain at the injection site
  • redness of the skin
  • 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

Minor Side Effects

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

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
Less common—for upper limb spasticity
  • Dry mouth
  • fever
  • headache
  • muscle aches
  • 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


Very common (10% or more): Neck pain (up to 16%), muscular weakness (up to 14%)
Common (1% to 10%): Musculoskeletal pain, muscle spasms, musculoskeletal stiffness
Uncommon (0.1% to 1%): Pain in extremity[Ref]


Very common (10% or more): Dysphagia (up to 18%), dry mouth (16%)
Common (1% to 10%): Diarrhea, nausea, oropharyngeal pain, lip disorder, viral gastroenteritis[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness, epilepsy
Uncommon (0.1% to 1%): Speech disorder, dysesthesia[Ref]


Common (1% to 10%): Injection site pain, injection site hematoma
Very rare (less than 0.01%): Spread of toxin
Frequency not reported: Injection site reaction, allergic dermatitis, localized allergic reactions (e.g., welling, edema, erythema, pruritus, rash), herpes zoster[Ref]


Common (1% to 10%): Dry eye (19%), eyelid ptosis (19%)
Uncommon (0.1% to 1%): Impaired vision, blurred vision, lacrimation increased, eye swelling, eyelid edema, diplopia[Ref]


Common (1% to 10%): Asthma, nasopharyngitis, respiratory tract infection, dyspnea, bronchitis[Ref]


Common (1% to 10%): Sinusitis, nasopharyngitis, respiratory tract infection, viral gastroenteritis, tooth infection
Postmarketing reports: Flu-like symptoms[Ref]


Common (1% to 10%): Hypertension[Ref]


Common (1% to 10%): Urinary tract infection[Ref]


Common (1% to 10%): Hypercholesterolemia, hyperglycemia[Ref]


Common (1% to 10%): Asthenia
Uncommon (0.1% to 1%): Dysphonia, facial paresis, feeling hot
Rare (less than 0.1%): Tenderness[Ref]


1. "Product Information. Xeomin (botulinum toxin type A (obsolete) (botulinum toxin type A))." Merz Pharmaceuticals, Greensboro, NC.

2. Cerner Multum, Inc. "Australian Product Information." O 0

Not all side effects for incobotulinumtoxinA may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.