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Introduction About NEURONOX INJECTION
NEURONOX INJECTION contains Botulinum Toxin Type A, which belongs to the group of medicines called Muscle relaxants. NEURONOX INJECTION is used to manage persistent muscle spasms in the elbow, wrist, and hand, ankle, and foot in children aged two years or older with cerebral palsy. NEURONOX INJECTION is used to support rehabilitation therapy. It is used to manage persistent muscle spasms in the hand, arm, shoulder, ankle or foot, eyelid and face, neck, and shoulders of adult patients.
NEURONOX INJECTION is used to manage headaches in adult patients with chronic migraine, overactive bladder with leakage of urine (the sudden urge to empty your bladder and needing to go to the toilet more than usual), and leakage of urine due to bladder problems associated with spinal cord injury or multiple sclerosis.
It is used to reduce excessive sweating of the armpits when other local treatments do not help. It is used for the temporary improvement in the appearance of vertical lines between the eyebrows seen at maximum frown and/or fan-shaped lines from the corner of the eyes seen at maximum smile and/or forehead lines seen at maximum raised eyebrows in adult patients.
NEURONOX INJECTION should be used with caution if you suffer from cardiovascular disease (disease of the heart or blood vessels). NEURONOX INJECTION is not recommended for use in pregnant and breastfeeding women.
The safety and effectiveness of NEURONOX INJECTION have been established in children and adolescents over the age of two years for the management of persistent muscle spasms in the elbow, wrist, and hand or ankle and foot, associated with cerebral palsy.
NEURONOX INJECTION should be used with caution in elderly patients aged 65 years and above with other serious illnesses. The most common side effects of using NEURONOX INJECTION are drooping of the eyelid, difficulty in swallowing, pain, muscle weakness, urinary tract infection, painful urination after the injection, inability to empty the bladder (urinary retention), and pain at the site of injection. Consult your doctor if any of the side effects worsen.
Uses Of NEURONOX INJECTION
- To manage persistent muscle spasms in the elbow, wrist, and hand, ankle, and foot in children aged two years or older with cerebral palsy
- To manage persistent muscle spasms in the hand, arm, shoulder, ankle or foot, eyelid and face, neck, and shoulders of adult patients
- To manage headaches in adult patients with chronic migraine
- To manage overactive bladder with leakage of urine
- To reduce excessive sweating of the armpits
- For the temporary improvement in the appearance of vertical lines between the eyebrows and/or fan-shaped lines from the corner of the eyes
How NEURONOX INJECTION Works
NEURONOX INJECTION works by partially blocking the nerve impulses to any muscles that have been injected and reduces excessive contractions of these muscles. In the case of chronic migraine, it is thought that NEURONOX INJECTION blocks pain signals, which indirectly blocks the development of a migraine.
When injected into the skin, NEURONOX INJECTION works on sweat glands to reduce the amount of sweat produced. When injected into the bladder wall, NEURONOX INJECTION works on the bladder muscle to stop leakage of urine (urinary incontinence) due to uncontrolled contractions of the bladder muscle.
How to use NEURONOX INJECTION
NEURONOX INJECTION will be administered only by a doctor or a nurse into your muscles (intramuscularly), into the bladder wall via a specific instrument (cystoscope) to inject into the bladder, or deep into the skin (intradermally). Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and disease condition.
Side Effects Of NEURONOX INJECTION
Common
- Upper respiratory tract infection
- Nausea, dry mouth, constipation
- Muscle weakness, tiredness
- Pain at the site of injection or injection site haematoma or bruising
- Problems with walking
- Rash, irritation, itching, numbness
- Pain or swelling in the hand and fingers
- Fall
- Joint pain or inflammation
- Neck pain, muscle pain, stiff or sore muscles, increased muscle tension
- Dizziness, sleepiness, headache
- Feeling of weakness or generally unwell
- Flu manifestations
- Increase in headache or migraine
- Weakness of the face muscles
- Drooping of the eyelid
- Urinary tract infection, painful urination after the injection
- Inability to empty the bladder (urinary retention)
- Incomplete emptying of the bladder, frequent daytime urination
- Abdominal pain, lower abdominal pain
- Face pain
- Skin redness, hot flushes
- Hair loss
Uncommon
- Drooping of the muscles on one side of the face
- Double vision, fever
- Visual disturbance, blurred vision
- Inflammation of the eyelid, eye pain
- inflammation of the cornea (transparent surface covering the front of the eye), abnormal turning of the eyelids outwards or inwards
- changes in voice
- Skin pain, jaw pain
- Anxiety
- skin sensitivity to light, dry skin, itching
- Muscle twitching
- Mephisto sign (raising of the outer eyebrows)
- Injection site tingling or numbness
Rare
Stop receiving NEURONOX INJECTION and inform your doctor immediately if you experience any of the following side effects:
- symptoms of severe allergic reaction such as hives, swelling of the face or throat causing wheezing, difficulty in breathing, swallowing, or speaking, feeling faint, and shortness of breath (possible)
- difficulty in breathing, swallowing, or speaking after receiving BOTOX,
How To Manage Side Effects
Constipation
Try to eat more high-fiber foods such as fresh fruit, vegetables, and cereals, and drink plenty of water. If this does not help, consult your doctor about receiving alternate management for constipation.
Dizziness Or Drowsiness
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol. Consult your doctor if your dizziness worsens.
Headache
Rest and relax. Keep yourself hydrated by drinking plenty of fluids, such as water or electrolytes. Applying pain-relieving balm to your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
Nausea And Vomiting
Take NEURONOX INJECTION with or just after meals. Stick to simple meals. Avoid eating oily or spicy foods. Consult your doctor if your nausea worsens.
Skin rash Or Itching
Avoid hot baths because hot water can irritate your skin further. Do not scratch the affected area. Use sunscreen and wear protective clothing while going outside. Use unscented moisturizers to soothe and hydrate the affected area. Contact your doctor if your rashes worsen.
Stomach Pain
Try to rest and relax. Eat and drink slowly or try to eat smaller meals more frequently. Keep a heat pad on your stomach. Consult your doctor if the stomach pain does not improve.
Warning & Precautions
Pregnancy
ContraindicatedNEURONOX INJECTION is not recommended for use during pregnancy, and women of childbearing potential are not using contraception.
Breastfeeding
ContraindicatedNEURONOX INJECTION is not recommended for use in breastfeeding women.
Driving and Using Machines
Use with CautionDo not drive or operate any machinery if you feel dizziness, sleepiness, tiredness, or problems with your vision.
Allergy
ContraindicatedNEURONOX INJECTION is not recommended for use if you are allergic to botulinum toxin type A or any other ingredients in this medicine.
Heart Disease
Use with CautionNEURONOX INJECTION should be used with caution if you suffer from cardiovascular disease (disease of the heart or blood vessels).
Use In Pediatrics
Consult your doctorThe safety and effectiveness of NEURONOX INJECTION have been established in children and adolescents over the age of two years for the management of persistent muscle spasms in the elbow, wrist, and hand or ankle and foot, associated with cerebral palsy. Consult your child’s doctor for advice.
Use In Geriatrics
Use with CautionNEURONOX INJECTION should be used with caution in elderly patients aged 65 years and above with other serious illnesses. There is limited experience of using NEURONOX INJECTION in the management of vertical and/or fan-shaped and/or forehead lines in patients older than 65 years.
Others
NEURONOX INJECTION is not recommended for use if:
- you have an infection at the proposed site of injection
- you are being treated for leakage of urine and have either a urinary tract infection or a sudden inability to empty your bladder (and are not regularly using a catheter)
- you have bladder stones
- you are being treated for leakage of urine and are not willing to begin using a catheter if required
Before receiving NEURONOX INJECTION, inform your doctor if you:
- ever had problems with swallowing or food or liquid accidentally going into your lungs, especially if you will be treated for persistent muscle spasms in the neck and shoulders
- suffer from muscle problems or chronic diseases affecting your muscles (such as myasthenia gravis or Eaton Lambert Syndrome)
- suffer from certain diseases affecting your nervous system (such as amyotrophic lateral sclerosis or motor neuropathy)
- have significant weakness or wasting of the muscles
- have a history of any surgery that affects the muscle to be injected
- have a previous history of fainting after receiving injection
- have inflammation in the muscles or skin at the site of injection
- have had problems in the past with previous botulinum toxin injections
- have seizures
- have closed-angle glaucoma (high pressure in the eye) or are at risk for developing this type of glaucoma
- are scheduled for operation
Interactions
A. Drug-Drug Interactions:
Inform your physician if you are taking any of the following drugs before using NEURONOX INJECTION:
- Anticoagulants (blood thinners) (Ex. warfarin)
- Antibiotics (Ex. gentamicin, tobramycin)
- Anticholinesterase (Ex. neostigmine, pyridostigmine)
- Muscle relaxants (Ex. diazepam, baclofen)
- Antiplatelets (Ex. aspirin, clopidogrel)
B. Drug-food interactions:
NA
Overdose:
NEURONOX INJECTION will be given to you only by a doctor or nurse in a hospital, and so it is unlikely to result in an overdose. If you have received too much of NEURONOX INJECTION, you will experience muscle weakness, difficulty breathing, swallowing, or speaking due to muscle paralysis; food or liquid accidentally going into your lungs, which might cause pneumonia (infection of the lungs) due to muscle paralysis; drooping of the eyelids; double vision; and generalized weakness.
Synopsis
| Drug | : | Botulinum Toxin Type A |
| Pharmacological Category | : | Muscle Relaxants |
| Therapeutic Indication | : | To manage persistent muscles, headaches, an overactive bladder, and excessive sweating of the armpits |
| Dosage Forms | : | Injection |
More Information
Storage
- Keep NEURONOX INJECTION out of reach of children
- Store NEURONOX INJECTION in a refrigerator (2 °C–8 °C)
FAQs About NEURONOX INJECTION
Q: What are the side effects of NEURONOX INJECTION?
A: The most common side effects of using NEURONOX INJECTION are drooping of the eyelid, difficulty in swallowing, pain, muscle weakness, urinary tract infection, painful urination after the injection, inability to empty the bladder (urinary retention), and pain at the site of injection. Consult your doctor if any of the side effects worsen.
Q: What is the use of NEURONOX INJECTION?
A: NEURONOX INJECTION is used to manage persistent muscle spasms in the elbow, wrist, and hand, ankle, and foot in children aged two years or older with cerebral palsy and persistent muscle spasms in the hand, arm, shoulder, ankle, or foot, eyelid and face, neck, and shoulders of adult patients.
NEURONOX INJECTION is used to manage headaches in adult patients with chronic migraine, overactive bladder with leakage of urine, and leakage of urine due to bladder problems associated with spinal cord injury or multiple sclerosis.
It is used to reduce excessive sweating of the armpits when other local treatments do not help. It is used for the temporary improvement in the appearance of vertical lines between the eyebrows and/or fan-shaped lines from the corner of the eyes in adult patients.
Q: How NEURONOX INJECTION is given?
A: NEURONOX INJECTION will be administered only by a doctor or a nurse into your muscles (intramuscularly), into the bladder wall via a specific instrument (cystoscope) to inject into the bladder, or deep into the skin (intradermally). Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and disease condition.
Q: How does NEURONOX INJECTION work?
A: NEURONOX INJECTION works by partially blocking the nerve impulses to any muscles that have been injected and reduces excessive contractions of these muscles. In the case of chronic migraine, it is thought that NEURONOX INJECTION blocks pain signals, which indirectly blocks the development of a migraine.
When injected into the skin, NEURONOX INJECTION works on sweat glands to reduce the amount of sweat produced. When injected into the bladder wall, NEURONOX INJECTION works on the bladder muscle to stop leakage of urine (urinary incontinence) due to uncontrolled contractions of the bladder muscle.
Q: Is NEURONOX INJECTION safe during pregnancy?
A: NEURONOX INJECTION is not recommended for use during pregnancy, and women of childbearing potential are not using contraception.
Q: Can NEURONOX INJECTION be used in children?
A: The safety and effectiveness of NEURONOX INJECTION have been established in children and adolescents over the age of two years for the management of persistent muscle spasms in the elbow, wrist, and hand or ankle and foot, associated with cerebral palsy. Consult your child’s doctor for advice.
Q: Who should avoid using NEURONOX INJECTION?
A: NEURONOX INJECTION is not recommended for use if you have an infection at the proposed site of injection, are being treated for leakage of urine and have either a urinary tract infection or a sudden inability to empty your bladder (and are not regularly using a catheter), have bladder stones, are being treated for leakage of urine and are not willing to begin using a catheter if required, or are allergic to botulinum toxin type A.
Q: What precautions must be taken while using NEURONOX INJECTION?
A: Before receiving NEURONOX INJECTION, inform your doctor if you have cardiovascular disease, ever had problems with swallowing or food or liquid accidentally going into your lungs, especially if you will be treated for persistent muscle spasms in the neck and shoulders, suffer from muscle problems or chronic diseases affecting your muscles (such as myasthenia gravis or Eaton Lambert Syndrome), amyotrophic lateral sclerosis or motor neuropathy, weakness or wasting of the muscles, history of any surgery that affects the muscle to be injected, pervious history of fainting after receiving injection, or have inflammation in the muscles or skin at the site of injection, have had problems in the past with previous botulinum toxin injections, seizures, closed-angle glaucoma (high pressure in the eye) or are at risk for developing this type of glaucoma, or are scheduled for operation
Q: Does NEURONOX INJECTION manage headaches?
A: NEURONOX INJECTION is used to manage headaches in adult patients with chronic migraine. It has been shown to significantly reduce the frequency of days with headaches and to improve the quality of life of patients suffering from chronic migraine. After two treatment sessions, approximately 47% of patients had a 50% or greater reduction from baseline in the number of days with headaches they experienced.
Q: Can I drive after the procedure?
A: Do not drive or operate any machinery if you feel dizziness, sleepiness, tiredness, or problems with your vision.
References
1. Inderbir S. Padda; Prasanna Tadi. Botulinum Toxin. Stat Pearls. 2023. [Accessed on 12th September 2024] https://www.ncbi.nlm.nih.gov/books/NBK557387/
2. Allergan Pharmaceuticals Ireland. Electronic Medicines Compendium (EMC). [Revised in April 2024] [Accessed on 12th September 2024] https://www.medicines.org.uk/emc/files/pil.859.pdf
3. Allergan Pharmaceuticals Ireland. Botulinum Toxin Type A. [Accessed on 12th September 2024] https://media.allergan.com/actavis/actavis/media/general/Oman-PIL-BOTOX-100U.pdf
4. Drug bank. Botulinum Toxin Type A. [Accessed on 12th September 2024] https://go.drugbank.com/drugs/DB00083
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