Botox injection contains Clostridium botulinum type A neurotoxin complex, which is a protein compound derived from the bacteria Clostridium botulinum. It contains a toxin called botulinum toxin type A, which is produced by this type of bacteria.

Botulinum toxin type A is a bacterial toxin that prevents nerves from functioning normally (a neurotoxin). It prevents nerves from releasing a chemical called acetylcholine, which is essential for the nerves to communicate with muscle cells. This toxin therefore prevents muscles from receiving nerve stimulation.

Preventing nerve stimulation of muscles causes the muscles to become paralysed. Botulinum toxin type A causes muscle paralysis until such time as the nerve develops new endings to communicate with the muscles. Therefore, it is useful in treating conditions where excessive nerve stimulation to muscles is causing abnormal muscle functioning or spasms. It is injected into the muscle for this purpose.

The toxin is also useful for preventing excessive sweating, as it prevents nerve signals from reaching the sweat glands in the same manner. For this purpose the toxin is injected into the skin in the armpit.

What is it used for?

* Uncontrolled blinking or continuous closure of the eyelid (blepharospasm)
* Muscle spasm affecting one side of the face (hemifacial spasm)
* Spasmodic rotation of the head to one side (spasmodic torticollis/idiopathic cervical dystonia)
* Wrist and hand disability in adults due to spasm of the muscle in the upper arm as a result of a stroke
* Foot deformity due to spasm of leg muscles in children with cerebral palsy aged two years and over (dynamic equinus foot deformity)
* Severe excessive sweating from the armpits (hyperhidrosis), not controlled by antiperspirants

Warning!

* If your symptoms start to improve on this medicine, make sure you resume your normal activities gradually. Try not to do too much too quickly as you may risk injury.
* If you or someone you are caring for develops any swallowing, speech or breathing problems after having treatment with this medicine, you should consult your doctor immediately.
* Too frequent or excessive use of this medicine can cause the body to produce antibodies against the medicine, which could make it less effective.

Use with caution in
* Inflammation in the area to be injected
* Excessive weakness or wasting in the muscle to be injected
* History of swallowing difficulties (dysphagia)
* History of seizures, eg epilepsy
* Disease involving the heart and blood vessels (cardiovascular disease)
* A neurological condition called amyotrophic lateral sclerosis, in which there is progressive degeneration of the nerves that activate the muscles
* People who have recently had surgery or are due to have surgery in the near future
* People at risk of closed angle glaucoma (applicable only to those being treated for blepharospasm)
* People who have had previous eye surgery (applicable only to those being treated for blepharospasm)
Not to be used in

* Infection at the proposed injection site
* Abnormal muscle weakness (myasthenia gravis)
* Chronic disease affecting the muscles (Eaton Lambert syndrome)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

* The safety of this medicine for use during pregnancy has not been established. It should not be used during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

* It is not known if this medicine passes into breast milk. It is not recommended for the treatment of women who are breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

General side effects:

* Pain, soreness or bruising at the injection site
* Misplaced injections may paralyse nearby muscles and excessive doses may paralyse muscles that are not near the injection site

* Fever (pyrexia)
* Flu-like symptoms
* Difficulty or pain when swallowing (dysphagia)
* Rash or itching

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.