Xeomin
Xeomin (incobotulinumtoxinA) is an injectable medication used to treat many movement problems, drooling, and frown lines, but it can have dangerous side effects if it spreads to areas outside of the injection. It's typically administered by a healthcare provider.
What is Xeomin (incobotulinumtoxinA)?
What is Xeomin (incobotulinumtoxinA) used for?
- Long-term excessive drooling (sialorrhea) in people 2 years and older
- Arm spasms in people 2 years and older
- Uncontrollable neck spasms (cervical dystonia) in adults
- Uncontrollable eye twitching (blepharospasm) in adults
- Frown lines in adults
How Xeomin (incobotulinumtoxinA) works
Xeomin (incobotulinumtoxinA) is a neuromuscular blocker. It's a toxin made from bacteria (Clostridium botulinum) that temporarily lowers muscle activity by stopping a chemical called acetylcholine from being released in your muscle. This is helpful to treat muscle spasms that are caused by many different conditions as well as frown lines, twitching, and drooling.
Drug facts
Side effects of Xeomin (incobotulinumtoxinA)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Excessive drooling:
- Need for tooth removal (5% in adults)
- Dry mouth (4% in adults)
- Diarrhea (4% in adults)
- High blood pressure (4% in adults)
- Fall (3% in adults)
- Bronchitis (3% in adults, 1% in children)
- Trouble speaking (3% in adults)
- Back pain (3% in adults)
- Dry eye (3% in adults)
Arm spasms:
- Seizure (3% in adults)
- Nose and throat infection (2% in adults, 3-6% in children)
- Bronchitis (2-3% in children)
Neck spasms:
- Trouble swallowing (13-18%)
- Nervous system problems (16-17%)
- Neck pain (7-15%)
- Infections (13-14%)
- Breathing problems (10-13%)
- Muscle weakness (7-11%)
- Pain at injection site (4-9%)
- Muscle or bone pain (4-7%)
Eye twitching:
- Drooping eyelid (19%)
- Dry eye (16%)
- Dry mouth (16%)
- Vision changes (e.g., blurred vision, 12%)
- Injection site reaction (11%)
- Diarrhea (8%)
- Headache (7%)
- Nose and throat infection (5%)
- Respiratory tract infection (5%)
- Shortness of breath (5%)
Frown lines:
- Headache (5%)
Less Common Side Effects
- Dry mouth
- Upper respiratory tract infection (e.g., cough, common cold)
- Sore throat or tonsils
- Viral respiratory tract infection
- Fall
- Pain in arms, legs, hands, or feet
- Headache
- Nausea or vomiting
Xeomin (incobotulinumtoxinA) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Trouble breathing or swallowing
The following Xeomin (incobotulinumtoxinA) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common—for cervical dystonia
Chills
difficulty with swallowing
lower back or side pain
muscle or bone pain
muscle weakness
painful or difficult urination
pain in the neck
Less common—for blepharospasm
Difficult or labored breathing
muscle aches
stuffy or runny nose
unusual tiredness or weakness
Less common—for sialorrhea
Blurred vision
cough producing mucus
difficulty breathing
dizziness
falls
headache
nervousness
pounding in the ears
slow or fast heartbeat
tightness in the chest
Less common—for upper limb spasticity
Body aches or pain
chills
ear congestion
headache
loss of voice
muscle aches
seizures
stuffy or runny nose
unusual tiredness or weakness
Rare—for glabellar lines
Itching, pain, redness, or swelling at the injection site
pain in the face
swelling of the eyelids
Incidence not known
Changes in patterns and rhythms of speech
fast heartbeat
hoarseness
irritation
joint pain, stiffness, or swelling
pain at the injection site
redness of the skin
slurred speech
swelling of the eyes or eyelids
swelling of the face, lips, hands, or feet
tightness in the chest
trouble with speaking
trouble breathing or swallowing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common—for upper limb spasticity
Rare—for glabellar lines
Drooping of the eyelids
increased blinking
twitching of the eyelids
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Xeomin (incobotulinumtoxinA)
Pros
- Works well to treat many different movement problems and frown lines
- Injected directly into the affected muscles
- Can see improvement in your condition within 7 days
- Effects typically last 3 to 4 months after each treatment
Cons
- Needs to be injected by a healthcare provider
- Injections can be uncomfortable
- Requires repeat injections since effects wear off over time
- Has a risk of swallowing, speaking, or breathing problems
- Brand only, so might be expensive
Common questions about Xeomin (incobotulinumtoxinA)
You'll need to watch out for side effects that can happen within hours to weeks after using Xeomin (incobotulinumtoxinA) that can interfere with your ability to drive safely. These side effects include muscle weakness, blurry vision, or drooping eyelids. If you experience any of these side effects, don't drive or do any dangerous activities and let your provider know.
There isn't enough information available to know if Xeomin (incobotulinumtoxinA) is safe to use during pregnancy. In animal studies, Xeomin (incobotulinumtoxinA) caused harm to unborn babies. Discuss the risks and benefits of using this medication during pregnancy with your provider.
No. Xeomin (incobotulinumtoxinA) is typically injected into your or your child's muscle by a healthcare provider at their office.
Muscle relaxants can cause you to have more muscle weakness when taking them before or after Xeomin (incobotulinumtoxinA), which can be dangerous. Let your provider know what medications you're taking before starting Xeomin (incobotulinumtoxinA).
In general, you should notice improvement in your symptoms within 7 days after injection. For excessive drooling, you should wait at least 4 months (16 weeks) between treatments. Most people notice reduced saliva for over 4 months after receiving Xeomin (incobotulinumtoxinA).
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Risks and warnings for Xeomin (incobotulinumtoxinA)
Xeomin (incobotulinumtoxinA) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Spread of toxin effects
- Risk factors: Children | History of muscle, eye, or lung conditions
Xeomin (incobotulinumtoxinA) has been linked to spreading to other body areas outside of the injection site and causing toxic effects, occurring hours to weeks after receiving Xeomin (incobotulinumtoxinA). This can cause serious side effects, such as unexplained muscle weakness, drooping eyelids, blurred or double vision, breathing or swallowing difficulty, slurred speech or trouble speaking, or the need to urinate more frequently. If you notice any of these side effects, seek medical help right away.
Difficulty swallowing or breathing
- Risk factors: History of swallowing or breathing problems | Small neck muscles | Using Xeomin (incobotulinumtoxinA) in certain muscles | Myasthenia gravis | Lambert-Eaton syndrome | Current muscle-nerve conditions
Xeomin (incobotulinumtoxinA) can cause life-threatening problems with swallowing or breathing by weakening muscles involved in these functions, occurring hours to weeks after receiving Xeomin (incobotulinumtoxinA). These effects can last for many months. Your risk is higher if you have certain conditions affecting your muscles or nerves, or if you're injecting Xeomin (incobotulinumtoxinA) in certain muscles (e.g., sternocleidomastoid muscles). If you notice any of these problems, seek medical help right away. If you have a history of swallowing or breathing problems, let your provider know before receiving Xeomin (incobotulinumtoxinA).
Eye problems due to reduced blinking
- Risk factors: Previous eye surgery | Certain nerve problems
Injecting Xeomin (incobotulinumtoxinA) in the eyelid muscle leads to reduced blinking, which can lead to eye problems like ulcers in your eye. You're at higher risk if you have a history of eye surgery or certain nerve problems. Your provider will make sure your eyes are okay and might prescribe an ointment or special contact lenses to protect your eye if there are any problems. Let your provider know if you exerience eye pain or irritation after receiving Xeomin (incobotulinumtoxinA).
Worsening of glaucoma
- Risk factors: History of angle-closure glaucoma
Xeomin (incobotulinumtoxinA) can cause worsening of certain types of glaucoma, since it can raise pressure in your eyes by dilating (widening) your pupils. Let your provider know if you have a history of glaucoma before starting Xeomin (incobotulinumtoxinA).
Drooping eyelids
- Risk factors: Using Xeomin (incobotulinumtoxinA) for frown lines | Using higher than recommended doses of Xeomin (incobotulinumtoxinA) | Using Xeomin (incobotulinumtoxinA) more frequently than recommended
Xeomin (incobotulinumtoxinA) can cause drooping eyelids in some people who use it to treat frown lines. Don't use Xeomin (incobotulinumtoxinA) more frequently than every 3 months to avoid this side effect. If you notice drooping eyelids after you receive Xeomin (incobotulinumtoxinA), let your provider know.
Xeomin (incobotulinumtoxinA) dosage
Typical dosage for Xeomin (incobotulinumtoxinA)
Xeomin (incobotulinumtoxinA) is only available as an injection that's administered by a healthcare provider. The dose will depend on the condition you have.
Interactions between Xeomin (incobotulinumtoxinA) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Xeomin (incobotulinumtoxinA) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Xeomin (incobotulinumtoxinA) will not be safe for you to take.
- Infection at injection site
What are alternatives to Xeomin (incobotulinumtoxinA)?
Temporarily improves the appearance of moderate to severe facial lines, including:
News about Xeomin (incobotulinumtoxinA)
Xeomin (incobotulinumtoxinA) images
