BOTOX® belongs to a class of drugs called botulinum toxins. BOTOX®, a focal muscle-relaxing agent, is the brand of botulinum toxin type A made by Allergan. BOTOX® is the most studied brand of botulinum toxins and has been used to treat over one million patients worldwide for more than 11 years.

The following represent questions frequently asked by your patients.

BOTOX® is indicated for the treatment of cervical dystonia in adults to decrease the severity of abnormal head position and neck pain associated with cervical dystonia.

BOTOX® is indicated for the treatment of strabismus and blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders in patients 12 years of age and above.



BOTOX® is a formulation of botulinum toxin type A. It is derived from the bacterium Clostridium botulinum. This bacterium produces a protein that blocks the release of acetylcholine and relaxes muscles. Type A is just one of seven different types of botulinum toxin (A, B, C1, D, E, F, and G), and each has different properties and actions. No two of these botulinum toxins are alike.

More than 100 years of research have expanded our knowledge of botulinum toxin type A from the identification of the bacterium Clostridium botulinum to the commercialization of botulinum toxin type A as BOTOX®.

In the 1960s, the muscle-relaxing properties of botulinum toxin type A were tapped for investigational use in realigning crossed eyes. These early studies paved the way for treating other conditions caused by overactive muscles with botulinum toxin type A.

Today, BOTOX® is produced in controlled laboratory conditions and given in extremely small therapeutic doses. It has helped over 1 million patients worldwide with conditions caused by overactive muscles.

BOTOX® is indicated for the treatment of cervical dystonia in adults to decrease the severity of abnormal head position and associated neck pain. BOTOX® is also indicated for the treatment of blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders in people 12 years of age and above.



No. BOTOX® has been used for more than 11 years to treat over one million patients worldwide, and it is approved by the health ministries of at least 70 countries.



BOTOX® is Allergan’s brand of botulinum toxin type A. A brand of botulinum toxin type B is also now available. The two toxins are different in several ways:

• They are different serotypes
• They have different manufacturing processes
• They work differently
• They require different doses

BOTOX® differs from oral therapies in that it is a non-systemic, focal therapy. When drugs are taken orally, they are distributed throughout the body by the blood system. The drugs reach not only their desired site of action but also many additional sites. In contrast, BOTOX® is administered directly into the desired site of action. BOTOX® is not expected to be present in the blood stream at measurable levels following injection at the recommended doses.



BOTOX® provides targeted relief of symptoms for the treatment of neck pain and abnormal head position in cervical dystonia with

• No GI upset
• No fatigue
• No confusion
• No depression
• No liver toxicity

BOTOX® has been proven as a safe and effective therapy, and has been widely used for more than 11 years.

Over the past 20 years, BOTOX® has been evaluated in more than 200 studies specific to approved indications in the U.S. Currently, little clinical data are published about botulinum toxin type B.



Normally, your brain sends electrochemical messages to your muscles to make them contract and move. These messages are transmitted from a nerve to the muscle by a substance called acetylcholine. When too much acetylcholine is released, muscles become overly active and spasm or tense up.

BOTOX® blocks the nerve from releasing acetylcholine. As a result, the muscle spasms stop or are greatly reduced, providing prolonged relief from symptoms. Your health care provider will address how much BOTOX® is needed to treat you optimally.


It’s important to remember that botulinum toxin treatment is not a cure. For many people, however, its effects have been dramatic. With BOTOX®, the nerve will take about three months to recover and begin to release acetylcholine, and the muscles may become overactive again. At that point, another injection will be needed to provide relief, as long as no allergic reactions or other significant side effects occurred and adequate clinical response was obtained.



Each treatment typically lasts three months and can be repeated as long as your condition responds to BOTOX® and you do not have any serious allergic reactions or other significant side effects. BOTOX® has been used for more than 11 years to treat more than one million patients worldwide, and although formal, long-term clinical evaluations have not been conducted, its safety for long term use is supported by the reported and continuing studies conducted to date as well as by years of successful clinical experience.

Although most people continue to respond to BOTOX® injections, some people have experienced a diminished response over time. There may be several explanations for this:

1. Changes in your condition - If the pattern of your muscle activity changes, your health care provider may need to inject new muscles and/or change your dose. Identifying and injecting the affected muscle can be difficult, complicated by the changing pattern of muscle involvement and progression of the disorder.
2. Setting appropriate expectations - You may believe your first BOTOX® injection was more helpful than subsequent injections. That’s because your condition was perhaps quite severe when you had your first injection. Subsequent injections are usually given before your condition becomes that severe again. Therefore, the relief you experienced with subsequent injections may not have been as dramatic as the first time.
3. Antibody formation - When foreign proteins, like botulinum toxins, enter your body, antibodies may form. If antibodies to botulinum toxin develop, you may no longer respond to treatment.

Because botulinum toxins are usually used to treat chronic conditions, it’s important to preserve responsiveness to therapy.




BOTOX® is injected into the affected muscle(s). Your doctor will determine which muscles need to be treated.



Some people report minor, temporary discomfort from the injection. BOTOX® is reconstituted with sterile, preservative-free, normal saline for injection. The neutral pH of the injected solution, in combination with the fine-gauge needle your doctor will use, can help to minimize any injection-related pain.



If you’re receiving BOTOX® for cervical dystonia, you’ll usually see the effects within two weeks of the injection. If you’re receiving BOTOX® for blepharospasm, you’ll usually see effects within three days.



BOTOX® generally offers sustained relief, dose after dose. The relief you’ll feel from one treatment of BOTOX® will normally last for about three months. Treatments can be continued as long as your condition responds to BOTOX®, and you do not have any serious allergic reactions or other significant side effects. When the relief begins to fade, you’ll return to your doctor for your next treatment.

Usually, BOTOX® treatment is required approximately four times per year. Because symptoms can change over time, the amount and duration of relief you’ll experience can vary. Consult your doctor, who can determine how to achieve the best possible results with BOTOX®.



You and your healthcare provider mutually will decide if Botox® is the appropriate therapy for you. In order to make the right treatment decision, you should discuss the following with your health care provider before choosing treatment:

• Clinical experience with the drug
• Effectiveness and side effects

Make sure your health care provider knows if you are pregnant, nursing, or taking any medications before receiving BOTOX® injections. Additionally, you should not receive BOTOX® if you have an infection at the injection site. BOTOX® should be used with caution if you have other neurological diseases or disorders, or if you are taking aminoglycoside antibiotics or other drugs that interfere with neuromuscular transmission. Be sure to tell your health care provider about any prescription or over-the-counter medications you are taking before receiving BOTOX®.



Your health care provider is the best source of information about your condition and its treatment. However, there are several organizations that you may also find helpful:

Benign Essential Blepharospasm
Research Foundation (BEBRF)
(409) 832-0788
www.blepharospasm.org

Dystonia Medical Research
Foundation (DMRF)
(312) 755-0198 • (800) 377-DYST
www.dystonia-foundation.org

ST/Dystonia, Inc.
(262) 560-9534 • (888) 445-4588
www.spasmodictorticollis.org

The National Spasmodic Torticollis Association (NSTA)
(714) 378-7837 • (800) 487-8385
www.torticollis.org

WE MOVE—Worldwide Education and Awareness for Movement Disorders
(800) 437-MOV2
www.wemove.org

For more information on BOTOX® contact us through this Web site:
Contact Us
or call 1-800-44-BOTOX®