BOTOX B

What is BOTOX B?

Botulinum toxin (abbreviated either as BTX or BoNT) is produced by Clostridium botulinum, a gram-positive anaerobic bacterium. The clinical syndrome of botulism can occur following ingestion of contaminated food, from colonization of the infant gastrointestinal tract, or from a wound infection.

BoNT is broken into 7 neurotoxins (labeled as types A, B, C [C1, C2], D, E, F, and G), which are antigenically and serologically distinct but structurally similar. Human botulism is caused mainly by types A, B, E, and (rarely) F. Types C and D cause toxicity only in animals.

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What are the botox products?

The various botulinum toxins possess individual potencies, and care is required to assure proper use and avoid medication errors. Recent changes to the established drug names by the FDA were intended to reinforce these differences and prevent medication errors. The products and their approved indications include the following:

1

OnabotulinumtoxinA (Botox®, Botox Cosmetic®)

Botox® – Cervical dystonia, severe primary axillary hyperhidrosis, strabismus, blepharospasm, neurogenic detrusor overactivity, chronic migraine, upper limb spasticity

Botox Cosmetic® – Moderate to severe glabellar lines, moderate to severe lateral canthal lines, known as crow’s feet

2

AbobotulinumtoxinA (Dysport®) - Upper and lower limb spasticity, cervical dystonia, and moderate-to-severe glabellar lines in adults; it is also indicated for lower limb spasticity in children aged 2 years or older

3

IncobotulinumtoxinA (Xeomin®) - Upper limb spasticity, cervical dystonia, blepharospasm, moderate to severe glabellar lines, chronic sialorrhea

4

PrabotulinumtoxinA (Jeuveau®) – Moderate-to-severe glabellar lines

5

RimabotulinumtoxinB (Myobloc®) - Cervical dystonia

The BoNT molecule is synthesized as a single chain (150 kD) and then cleaved to form the dichain molecule with a disulfide bridge.

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