HeadWise HeadWise: Volume 3, Issue 4 | Page 24

MEDICATION GUIDE BOTOX® and BOTOX® Cosmetic (Boe-tox) (onabotulinumtoxinA) for Injection Read the Medication Guide that comes with BOTOX or BOTOX Cosmetic before you start using it and each time it is given to you. There may be new information. This information does not take the place of talking with your doctor about your medical condition or your treatment. You should share this information with your family members and caregivers. What is the most important information I should know about BOTOX and BOTOX Cosmetic? BOTOX and BOTOX Cosmetic may cause serious side effects that can be life threatening, including: • Problems breathing or swallowing • Spread of toxin effects These problems can happen hours, days, to weeks after an injection of BOTOX or BOTOX Cosmetic. Call your doctor or get medical help right away if you have any of these problems after treatment with BOTOX or BOTOX Cosmetic: 1. Problems swallowing, speaking, or breathing. These problems can happen hours, days, to weeks after an injection of BOTOX or BOTOX Cosmetic usually because the muscles that you use to breathe and swallow can become weak after the injection. Death can happen as a complication if you have severe problems with swallowing or breathing after treatment with BOTOX or BOTOX Cosmetic. • People with certain breathing problems may need to use muscles in their neck to help them breathe. These people may be at greater risk for serious breathing problems with BOTOX or BOTOX Cosmetic. • Swallowing problems may last for several months. People who cannot swallow well may need a feeding tube to receive food and water. If swallowing problems are severe, food or liquids may go into your lungs. People who already have swallowing or breathing problems before receiving BOTOX or BOTOX Cosmetic have the highest risk of getting these problems. 2. Spread of toxin effects. In some cases, the effect of botulinum toxin may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism. The symptoms of botulism include: • loss of strength and muscle weakness all over the body 24 HeadW ise™ | Volume 3, Issue 4 • 141031_LOT A_NHFHeadWise–February.indd 24 • double vision • blurred vision and drooping eyelids • hoarseness or change or loss of voice (dysphonia) • trouble saying words clearly (dysarthria) • loss of bladder control • trouble breathing • trouble swallowing These symptoms can happen hours, days, to weeks after you receive an injection of BOTOX or BOTOX Cosmetic. These problems could make it unsafe for you to drive a car or do other dangerous activities. See “What should I avoid while receiving BOTOX or BOTOX Cosmetic?” There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX has been used at the recommended dose to treat chronic migraine, severe underarm sweating, blepharospasm, or strabismus, or when BOTOX Cosmetic has been used at the recommended dose to treat frown lines and/or crow’s feet lines. What are BOTOX and BOTOX Cosmetic? BOTOX is a prescription medicine that is injected into muscles and used: • to treat overactive bladder symptoms such as a strong need to urinate with leaking or wetting accidents (urge urinary incontinence), a strong need to urinate right away (urgency), and urinating often (frequency) in adults when another type of medicine (anticholinergic) does not work well enough or cannot be taken. • to treat leakage of urine (incontinence) in adults with overactive bladder due to neurologic disease when another type of medicine (anticholinergic) does not work well enough or cannot be taken. • to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day. • to treat increased muscle stiffness in elbow, wrist, and finger muscles in adults with upper limb spasticity. • to treat the abnormal head position and neck pain that happens with cervical dystonia (CD) in adults. • to treat certain types of eye muscle problems (strabismus) or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older. BOTOX is also injected into the skin to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough. BOTOX Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults for a short period of time (temporary). BOTOX Cosmetic is a prescription medicine that is injected into the area around the side of the eyes to improve the look of crow’s feet lines in adults for a short period of time (temporary). You may receive treatment for frown lines and crow’s feet lines at the same time. It is not known whether BOTOX is safe or effective in people younger than: • 18 years of age for treatment of urinary incontinence • 18 years of age for treatment of chronic migraine • 18 years of age for treatment of spasticity • 16 years of age for treatment of cervical dystonia • 18 years of age for treatment of hyperhidrosis • 12 years of age for treatment of strabismus or blepharospasm BOTOX Cosmetic is not recommended for use in children younger than 18 years of age. It is not known whether BOTOX and BOTOX Cosmetic are safe or effective to prevent headaches in people with migraine who have 14 or fewer headache days each month (episodic migraine). It is not known whether