Patients should be considered for reinjection when the clinical effect of the previous injection has diminished (median time until patients qualified for the second treatment of BOTOX in double-blind, placebo-controlled clinical studies was 169 days [~24 weeks]), but pelo sooner than 12 weeks from the prior bladder injection.
A one inch needle may be needed in the neck region for patients with thick neck muscles. With the exception of the procerus muscle, which should be injected at one sitio (midline), all muscles should be injected bilaterally with half the number of injection sites administered to the left, and half to the right side of the head and neck. The recommended re-treatment schedule is every 12 weeks.
There have been postmarketing reports of serious breathing difficulties, including respiratory failure.
Botox and Botox Cosmetic are purified forms of botulinum toxin that when injected in tiny, controlled doses are very safe and effective at relaxing excessive muscle contraction, even though ingestion of food contaminated with C. botulinum causes botulism - an often fatal, paralytic-type illness.
Botox wears off with time as new nerve endings sprout and gradually reconnect with muscles or sweat glands, allowing them to work normally again in the treated area.
Delayed-onset inflammation near the site of injection is one of the known adverse events associated with dermal fillers. Cases of delayed-onset inflammation have been reported to occur at the treatment site following viral or bacterial illnesses or infections, vaccinations, or dental procedures. Typically, the reported inflammation was responsive to treatment or resolved on its own.
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have weakness of your forehead muscles, such as trouble raising your eyebrows or drooping eyelids and plan to get onabotulinumtoxinA injection in your face
Treatment with BOTOX and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing [see Warnings and Precautions (5.
Botox is not approved for the prevention of of episodic migraine (14 headache days or fewer per month), and also should not be used to treat a common tension headache.
Reconstituted BOTOX (100 Units/10 mL) is injected into the detrusor muscle via a flexible or rigid cystoscope, avoiding the trigone. The bladder should be instilled with enough saline to achieve adequate visualization for the injections, but over-distension should be avoided.
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The initial dose for a patient without prior use of BOTOX should be at a lower dose, with subsequent dosing adjusted based on individual response. Limiting the Completa dose injected into the sternocleidomastoid muscle to 100 Units or less may decrease the occurrence of dysphagia.
WARNING: DISTANT SPREAD OF TOXIN EFFECT Postmarketing reports indicate that the effects of BOTOX and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death.