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BOTOX (ONABOTULINUMTOXINA)
- Migraine prevention
- Bladder hyperactivity
- Blepharospasm
- Lower limb spasticity
- Primary focal hyperhidrosis of axilla
- Spasmodic torticollis
- Strabismus
- Upper limb spasticity
- Urinary incontinence due to detrusor overactivity
100 unit injection
- Dosage information is not available
200 unit injection
- Dosage information is not available
- None
Contraindicated
- Adoxa
- amikacin
- Avidoxy
- Compound 347
- demeclocycline
- dextromethorphan-quinidine
- Doryx
- Doxy-100
- doxycycline calcium
- doxycycline hyclate
- doxycycline monohydrate
- enflurane
- Forane
- gentamicin
- gentamicin in NaCl (iso-osm)
- gentamicin sulfate (ped) (PF)
- gentamicin sulfate (PF)
- isoflurane
- Minocin
- minocycline
- Monodox
- Morgidox
- neomycin
- Nuedexta
- Oracea
- paromomycin
- Qualaquin
- quinidine gluconate
- quinidine sulfate
- quinine sulfate
- sevoflurane
- Sojourn
- Solodyn
- streptomycin
- Terrell
- tetracycline
- tigecycline
- tobramycin in 0.9 % NaCl
- tobramycin sulfate
- Tygacil
- Ultane
- Vibramycin
Severe
Moderate
- Acanya
- Baciim
- bacitracin
- Benzaclin
- Benzaclin Pump
- Capastat
- capreomycin
- Cerebyx
- Cleocin
- Cleocin In 5 % Dextrose
- Cleocin T
- Clindacin Etz
- Clindacin P
- Clindacin Pac
- Clindagel
- clindamycin HCl
- clindamycin in dextrose 5%
- clindamycin palmitate HCl
- Clindamycin Pediatric
- clindamycin phos-skin clnsr 19
- clindamycin phosphate
- clindamycin-benzoyl peroxide
- clindamycin-tretinoin
- Clindesse
- colistin (colistimethate Na)
- Coly-mycin M Parenteral
- Dilantin
- Dilantin Extended
- Dilantin Infatabs
- Dilantin Kapseal
- Dilantin-125
- Duac
- ethotoin
- Evoclin
- fosphenytoin
- Lincocin
- lincomycin
- Peganone
- Phenytek
- phenytoin
- phenytoin sodium
- phenytoin sodium extended
- polymyxin B sulfate
- vancomycin
- vancomycin in D5W
- vancomycin in dextrose iso-osm
- Veltin
- Ziana
- None
Contraindicated
- Amyotrophic lateral sclerosis
- Aspiration pneumonia
- Blepharoptosis
- Blurred vision
- Botulism
- Diplopia
- Dysarthria
- Dysphagia
- Dyspnea
- Eaton-lambert syndrome
- Myasthenia gravis
- Peripheral motor neuropathy
- Respiratory depression
- Urinary incontinence
Severe
Moderate
- Hoarseness
- Polyopia
BOTOX (ONABOTULINUMTOXINA)
- Migraine prevention
- Bladder hyperactivity
- Blepharospasm
- Lower limb spasticity
- Primary focal hyperhidrosis of axilla
- Spasmodic torticollis
- Strabismus
- Upper limb spasticity
- Urinary incontinence due to detrusor overactivity
- Dysphagia
- Lagophthalmos
- Muscle weakness
- Voice change
- Back pain
- Blepharoptosis
- Bronchitis
- Cough
- Dysuria
- Ecchymosis
- Eyelid edema
- Fatigue
- Headache disorder
- Influenza
- Injection site sequelae
- Nausea
- Neck pain
- Ocular irritation
- Pharyngitis
- Rhinitis
- Upper respiratory infection
- Urinary retention
- Urinary tract infection
- Xerostomia
More Frequent
Severe
Less Severe
- Diplopia
- Fever
- Infection
- Pruritus of skin
- Skin rash
- Visual changes
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute myocardial infarction
- Acute respiratory distress syndrome
- Anaphylaxis
- Aspiration pneumonia
- Botulism
- Brachial plexus disorder
- Cardiac arrhythmia
- Corneal ulcer
- Dysarthria
- Dyspnea
- Entropion
- Erythema
- Erythema multiforme
- Hearing loss
- Hematoma
- Hypersensitivity drug reaction
- Keratitis
- Muscle atrophy
- Respiratory depression
- Seizure disorder
- Serum sickness
- Urinary incontinence
Less Severe
- Acute abdominal pain
- Alopecia
- Anorexia
- Arthralgias
- Blurred vision
- Chest pain
- Diarrhea
- Dry eye
- Edema
- Excessive granulation tissue
- Facial palsy
- Flu-like symptoms
- Gait abnormality
- General weakness
- Heavy feeling
- Hematuria
- Hyperhidrosis
- Hypertonia
- Hypesthesia
- Malaise
- Musculoskeletal pain
- Myalgias
- Paresthesia
- Peripheral neuropathy
- Photophobia
- Psoriasiform eruption
- Retrobulbar hemorrhage
- Sinusitis
- Stinging of skin
- Strabismus
- Symptoms of anxiety
- Syncope
- Tinnitus
- Twitching
- Urticaria
- Vertigo
- Vomiting
Contraindicated
None
Severe Precaution
Onabotulinumtoxin A
Risk of toxin spread can be life threatening. Safety and effectiveness not established in age < 2 years
Risk of toxin spread can be life threatening. Indicated for upper or lower limb spasticity (age > 2 years), neurologic detrusor overactivity (age > 5 years), cervical dystonia (age > 16 years), and blepharospasm/strabismus (age > 12 years). Adhere to manufacturer dosing limits. No efficacy established for OAB, migraine prophylaxis or axillary hyperhidrosis.
- 1 Day – 2 Years
- Risk of toxin spread can be life threatening. Safety and effectiveness not established in age < 2 years
- Risk of toxin spread can be life threatening. Indicated for upper or lower limb spasticity (age > 2 years), neurologic detrusor overactivity (age > 5 years), cervical dystonia (age > 16 years), and blepharospasm/strabismus (age > 12 years). Adhere to manufacturer dosing limits. No efficacy established for OAB, migraine prophylaxis or axillary hyperhidrosis.
- 2 Years – 18 Years
- Risk of toxin spread can be life threatening. Safety and effectiveness not established in age < 2 years
- Risk of toxin spread can be life threatening. Indicated for upper or lower limb spasticity (age > 2 years), neurologic detrusor overactivity (age > 5 years), cervical dystonia (age > 16 years), and blepharospasm/strabismus (age > 12 years). Adhere to manufacturer dosing limits. No efficacy established for OAB, migraine prophylaxis or axillary hyperhidrosis.
Management or Monitoring Precaution
None
Onabotulinumtoxina
- Severity Level:
2
- Additional Notes: Insufficient human data available.
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Onabotulinumtoxina
Insufficient data available
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insufficient data available |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Onabotulinumtoxina
Urogenital-Elderly patients with overactive bladder may be at greater risk for UTI and urinary retention compared to younger patients.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | N | N | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- See also Uses section. This medication can spread to other parts of the body after your injection, causing serious (possibly fatal) side effects. These can occur hours or even weeks after the injection.<br /><br />However, the chances of such serious side effects occurring when this medication is used for migraines or skin conditions such as wrinkles, eye spasm, or excessive sweating are extremely unlikely. Children being treated for muscle stiffness/spasms have the greatest risk of these effects, as well as anyone that has certain medical conditions (see Precautions section). Discuss the risks and benefits of this medication with your doctor. Get medical help right away if any of these very serious side effects occur: chest pain, difficulty breathing, excessive muscle weakness, irregular heartbeat, severe difficulty swallowing or speaking, loss of bladder control.
| Bladder hyperactivity | |
| N32.81 | Overactive bladder |
| Blepharospasm | |
| G24.5 | Blepharospasm |
| Lower limb spasticity | |
| G04.1 | Tropical spastic paraplegia |
| G11.4 | Hereditary spastic paraplegia |
| G80.0 | Spastic quadriplegic cerebral palsy |
| G80.1 | Spastic diplegic cerebral palsy |
| G80.2 | Spastic hemiplegic cerebral palsy |
| G81.1 | Spastic hemiplegia |
| G81.10 | Spastic hemiplegia affecting unspecified side |
| G81.11 | Spastic hemiplegia affecting right dominant side |
| G81.12 | Spastic hemiplegia affecting left dominant side |
| G81.13 | Spastic hemiplegia affecting right nondominant side |
| G81.14 | Spastic hemiplegia affecting left nondominant side |
| M62.838 | Other muscle spasm |
| Migraine prevention | |
| G43 | Migraine |
| G43.0 | Migraine without aura |
| G43.00 | Migraine without aura, not intractable |
| G43.009 | Migraine without aura, not intractable, without status migrainosus |
| G43.01 | Migraine without aura, intractable |
| G43.019 | Migraine without aura, intractable, without status migrainosus |
| G43.1 | Migraine with aura |
| G43.10 | Migraine with aura, not intractable |
| G43.109 | Migraine with aura, not intractable, without status migrainosus |
| G43.11 | Migraine with aura, intractable |
| G43.119 | Migraine with aura, intractable, without status migrainosus |
| G43.4 | Hemiplegic migraine |
| G43.40 | Hemiplegic migraine, not intractable |
| G43.409 | Hemiplegic migraine, not intractable, without status migrainosus |
| G43.41 | Hemiplegic migraine, intractable |
| G43.419 | Hemiplegic migraine, intractable, without status migrainosus |
| G43.5 | Persistent migraine aura without cerebral infarction |
| G43.50 | Persistent migraine aura without cerebral infarction, not intractable |
| G43.509 | Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus |
| G43.51 | Persistent migraine aura without cerebral infarction, intractable |
| G43.519 | Persistent migraine aura without cerebral infarction, intractable, without status migrainosus |
| G43.6 | Persistent migraine aura with cerebral infarction |
| G43.60 | Persistent migraine aura with cerebral infarction, not intractable |
| G43.609 | Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus |
| G43.61 | Persistent migraine aura with cerebral infarction, intractable |
| G43.619 | Persistent migraine aura with cerebral infarction, intractable, without status migrainosus |
| G43.7 | Chronic migraine without aura |
| G43.70 | Chronic migraine without aura, not intractable |
| G43.709 | Chronic migraine without aura, not intractable, without status migrainosus |
| G43.71 | Chronic migraine without aura, intractable |
| G43.719 | Chronic migraine without aura, intractable, without status migrainosus |
| G43.8 | Other migraine |
| G43.80 | Other migraine, not intractable |
| G43.809 | Other migraine, not intractable, without status migrainosus |
| G43.81 | Other migraine, intractable |
| G43.819 | Other migraine, intractable, without status migrainosus |
| G43.82 | Menstrual migraine, not intractable |
| G43.829 | Menstrual migraine, not intractable, without status migrainosus |
| G43.83 | Menstrual migraine, intractable |
| G43.839 | Menstrual migraine, intractable, without status migrainosus |
| G43.9 | Migraine, unspecified |
| G43.90 | Migraine, unspecified, not intractable |
| G43.909 | Migraine, unspecified, not intractable, without status migrainosus |
| G43.91 | Migraine, unspecified, intractable |
| G43.919 | Migraine, unspecified, intractable, without status migrainosus |
| G43.B | Ophthalmoplegic migraine |
| G43.B0 | Ophthalmoplegic migraine, not intractable |
| G43.B1 | Ophthalmoplegic migraine, intractable |
| G43.C | Periodic headache syndromes in child or adult |
| G43.C0 | Periodic headache syndromes in child or adult, not intractable |
| G43.C1 | Periodic headache syndromes in child or adult, intractable |
| G43.D | Abdominal migraine |
| G43.D0 | Abdominal migraine, not intractable |
| G43.D1 | Abdominal migraine, intractable |
| Primary focal hyperhidrosis of axilla | |
| L74.510 | Primary focal hyperhidrosis, axilla |
| Spasmodic torticollis | |
| G24.3 | Spasmodic torticollis |
| Strabismus | |
| H49.2 | Sixth [abducent] nerve palsy |
| H49.20 | Sixth [abducent] nerve palsy, unspecified eye |
| H49.21 | Sixth [abducent] nerve palsy, right eye |
| H49.22 | Sixth [abducent] nerve palsy, left eye |
| H49.23 | Sixth [abducent] nerve palsy, bilateral |
| H50.00 | Unspecified esotropia |
| H50.01 | Monocular esotropia |
| H50.011 | Monocular esotropia, right eye |
| H50.012 | Monocular esotropia, left eye |
| H50.10 | Unspecified exotropia |
| H50.11 | Monocular exotropia |
| H50.111 | Monocular exotropia, right eye |
| H50.112 | Monocular exotropia, left eye |
| H50.2 | Vertical strabismus |
| H50.21 | Vertical strabismus, right eye |
| H50.22 | Vertical strabismus, left eye |
| H50.9 | Unspecified strabismus |
| Upper limb spasticity | |
| G04.1 | Tropical spastic paraplegia |
| G11.4 | Hereditary spastic paraplegia |
| G80.0 | Spastic quadriplegic cerebral palsy |
| G80.1 | Spastic diplegic cerebral palsy |
| G80.2 | Spastic hemiplegic cerebral palsy |
| G81.1 | Spastic hemiplegia |
| G81.10 | Spastic hemiplegia affecting unspecified side |
| G81.11 | Spastic hemiplegia affecting right dominant side |
| G81.12 | Spastic hemiplegia affecting left dominant side |
| G81.13 | Spastic hemiplegia affecting right nondominant side |
| G81.14 | Spastic hemiplegia affecting left nondominant side |
| M62.838 | Other muscle spasm |
| Urinary incontinence due to detrusor overactivity | |
| N32.81 | Overactive bladder |
| 0-9 | A-Z |
|---|---|
| G04.1 | Tropical spastic paraplegia |
| G04.1 | Tropical spastic paraplegia |
| G11.4 | Hereditary spastic paraplegia |
| G11.4 | Hereditary spastic paraplegia |
| G24.3 | Spasmodic torticollis |
| G24.5 | Blepharospasm |
| G43 | Migraine |
| G43.0 | Migraine without aura |
| G43.00 | Migraine without aura, not intractable |
| G43.009 | Migraine without aura, not intractable, without status migrainosus |
| G43.01 | Migraine without aura, intractable |
| G43.019 | Migraine without aura, intractable, without status migrainosus |
| G43.1 | Migraine with aura |
| G43.10 | Migraine with aura, not intractable |
| G43.109 | Migraine with aura, not intractable, without status migrainosus |
| G43.11 | Migraine with aura, intractable |
| G43.119 | Migraine with aura, intractable, without status migrainosus |
| G43.4 | Hemiplegic migraine |
| G43.40 | Hemiplegic migraine, not intractable |
| G43.409 | Hemiplegic migraine, not intractable, without status migrainosus |
| G43.41 | Hemiplegic migraine, intractable |
| G43.419 | Hemiplegic migraine, intractable, without status migrainosus |
| G43.5 | Persistent migraine aura without cerebral infarction |
| G43.50 | Persistent migraine aura without cerebral infarction, not intractable |
| G43.509 | Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus |
| G43.51 | Persistent migraine aura without cerebral infarction, intractable |
| G43.519 | Persistent migraine aura without cerebral infarction, intractable, without status migrainosus |
| G43.6 | Persistent migraine aura with cerebral infarction |
| G43.60 | Persistent migraine aura with cerebral infarction, not intractable |
| G43.609 | Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus |
| G43.61 | Persistent migraine aura with cerebral infarction, intractable |
| G43.619 | Persistent migraine aura with cerebral infarction, intractable, without status migrainosus |
| G43.7 | Chronic migraine without aura |
| G43.70 | Chronic migraine without aura, not intractable |
| G43.709 | Chronic migraine without aura, not intractable, without status migrainosus |
| G43.71 | Chronic migraine without aura, intractable |
| G43.719 | Chronic migraine without aura, intractable, without status migrainosus |
| G43.8 | Other migraine |
| G43.80 | Other migraine, not intractable |
| G43.809 | Other migraine, not intractable, without status migrainosus |
| G43.81 | Other migraine, intractable |
| G43.819 | Other migraine, intractable, without status migrainosus |
| G43.82 | Menstrual migraine, not intractable |
| G43.829 | Menstrual migraine, not intractable, without status migrainosus |
| G43.83 | Menstrual migraine, intractable |
| G43.839 | Menstrual migraine, intractable, without status migrainosus |
| G43.9 | Migraine, unspecified |
| G43.90 | Migraine, unspecified, not intractable |
| G43.909 | Migraine, unspecified, not intractable, without status migrainosus |
| G43.91 | Migraine, unspecified, intractable |
| G43.919 | Migraine, unspecified, intractable, without status migrainosus |
| G43.B | Ophthalmoplegic migraine |
| G43.B0 | Ophthalmoplegic migraine, not intractable |
| G43.B1 | Ophthalmoplegic migraine, intractable |
| G43.C | Periodic headache syndromes in child or adult |
| G43.C0 | Periodic headache syndromes in child or adult, not intractable |
| G43.C1 | Periodic headache syndromes in child or adult, intractable |
| G43.D | Abdominal migraine |
| G43.D0 | Abdominal migraine, not intractable |
| G43.D1 | Abdominal migraine, intractable |
| G80.0 | Spastic quadriplegic cerebral palsy |
| G80.0 | Spastic quadriplegic cerebral palsy |
| G80.1 | Spastic diplegic cerebral palsy |
| G80.1 | Spastic diplegic cerebral palsy |
| G80.2 | Spastic hemiplegic cerebral palsy |
| G80.2 | Spastic hemiplegic cerebral palsy |
| G81.1 | Spastic hemiplegia |
| G81.1 | Spastic hemiplegia |
| G81.10 | Spastic hemiplegia affecting unspecified side |
| G81.10 | Spastic hemiplegia affecting unspecified side |
| G81.11 | Spastic hemiplegia affecting right dominant side |
| G81.11 | Spastic hemiplegia affecting right dominant side |
| G81.12 | Spastic hemiplegia affecting left dominant side |
| G81.12 | Spastic hemiplegia affecting left dominant side |
| G81.13 | Spastic hemiplegia affecting right nondominant side |
| G81.13 | Spastic hemiplegia affecting right nondominant side |
| G81.14 | Spastic hemiplegia affecting left nondominant side |
| G81.14 | Spastic hemiplegia affecting left nondominant side |
| H49.2 | Sixth [abducent] nerve palsy |
| H49.20 | Sixth [abducent] nerve palsy, unspecified eye |
| H49.21 | Sixth [abducent] nerve palsy, right eye |
| H49.22 | Sixth [abducent] nerve palsy, left eye |
| H49.23 | Sixth [abducent] nerve palsy, bilateral |
| H50.00 | Unspecified esotropia |
| H50.01 | Monocular esotropia |
| H50.011 | Monocular esotropia, right eye |
| H50.012 | Monocular esotropia, left eye |
| H50.10 | Unspecified exotropia |
| H50.11 | Monocular exotropia |
| H50.111 | Monocular exotropia, right eye |
| H50.112 | Monocular exotropia, left eye |
| H50.2 | Vertical strabismus |
| H50.21 | Vertical strabismus, right eye |
| H50.22 | Vertical strabismus, left eye |
| H50.9 | Unspecified strabismus |
| L74.510 | Primary focal hyperhidrosis, axilla |
| M62.838 | Other muscle spasm |
| M62.838 | Other muscle spasm |
| N32.81 | Overactive bladder |
| N32.81 | Overactive bladder |
Formulary Reference Tool