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Xeomin

incobotulinumtoxina
Used for Cervical Dystonia
Used for Cervical Dystonia

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.

Last reviewed on January 12, 2022
basics-icon

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.

Are you looking for information on Botox (onabotulinumtoxinA) or Dysport (abobotulinumtoxinA) instead?

Drug Facts

Common BrandsXeomin
Drug ClassNeuromuscular blocker
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the 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%)

Other 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

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Trouble breathing or swallowing

Source: DailyMed

The following 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 blepharospasm

Dry eyes

fever

More common—for cervical dystonia

Chills

cough

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

sneezing

sore throat

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

sore throat

tightness in the chest

Less common—for upper limb spasticity

Body aches or pain

chills

cough

ear congestion

fever

headache

loss of voice

muscle aches

seizures

sore throat

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

fever

hives, itching, or rash

hoarseness

irritation

joint pain, stiffness, or swelling

muscle spasm

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:

More common—for blepharospasm

Blurred vision

diarrhea

drooping upper eyelids

dry mouth

headache

Less common—for sialorrhea

Back pain

diarrhea

dry eye

dry mouth

hoarseness

voice changes

Less common—for upper limb spasticity

Dry mouth

Rare—for glabellar lines

Drooping of the eyelids

increased blinking

twitching of the eyelids

Incidence not known

Difficulty with moving

joint pain or swelling

muscle ache, cramps, pain, or stiffness

nausea

painful blisters on the trunk of the body

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

Pros and cons of Xeomin (incobotulinumtoxinA)

thumbs-up

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

thumbs-down

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

faqs

Frequently asked questions about Xeomin (incobotulinumtoxinA)

Will I be able to drive after getting my Xeomin (incobotulinumtoxinA) injection?
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.
Is it safe to use Xeomin (incobotulinumtoxinA) during pregnancy?
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.
Can I use Xeomin (incobotulinumtoxinA) at home?
No. Xeomin (incobotulinumtoxinA) is typically injected into your or your child's muscle by a healthcare provider at their office.
Can I use a muscle relaxant while taking Xeomin (incobotulinumtoxinA)?
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).
How soon does Xeomin (incobotulinumtoxinA) work, and how often can I use it to treat excessive drooling?
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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What are the 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.

risk-warning

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.

    risk-warning

    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).

      risk-warning

      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).

        risk-warning

        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).

          risk-warning

          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.

            dosage

            Xeomin (incobotulinumtoxinA) dosage forms

            Typical dosing 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

            Interactions between Xeomin (incobotulinumtoxinA) and other drugs

            Xeomin (incobotulinumtoxinA) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Xeomin (incobotulinumtoxinA). Please note that only the generic name of each medication is listed below.

            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.

            contraindications-icon

            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

            alternatives

            What are alternatives to Xeomin (incobotulinumtoxinA)?

            There are a number of medications that your doctor can prescribe in place of Xeomin (incobotulinumtoxinA). Compare a few possible alternatives below.
            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

            Used for:
            • Temporarily improves the appearance of frown lines, forehead lines, and crow's feet lines in adults

            $367.81 Lowest GoodRx priceView Prices
            Used for:
            • Neck spasms (cervical dystonia) in adults

            • Frown lines in adults under 65 years old

            • Muscle spasms in upper and lower limbs in adults and children age 2 years and older

            $540.24 Lowest GoodRx priceView Prices
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            Xeomin (incobotulinumtoxinA) images

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