1 April 2009

The use of botulinum toxin is now reported to be of benefit in over thirty conditions. This increased use means doctors now need to be more aware of the potential adverse effects, Dr Adam Scheinberg of the Victorian Paediatric Rehabilitation Service warns in the latest edition of Australian Prescriber.

Botulinum toxin is used to relax muscles or decrease sweat gland activity. As the effect of the toxin wears off after three to four months, repeat doses are usually required. The effect on muscle relaxation may be prolonged by stretching, splinting and strengthening antagonist muscles.

“The recommended dose depends on which preparation of botulinum toxin type A is used. The two products available in Australia are of different potency. The dosage depends on the size of the muscle or gland being injected, and the method used to localise the injection site,” Dr Scheinberg writes.

“Adverse events tend to occur one to two weeks after injection and are usually transient. Although uncommon, serious adverse effects including generalised weakness and dysphagia have been reported.”

There have also been some deaths in children and adults although the cause of their deaths was unclear. “Caution is recommended in patients who are significantly debilitated or who have risk factors such as severe dysphagia,” Dr Scheinberg says.

For a full copy of the article visit www.australianprescriber.com.

For further advice health professionals can call the NPS Therapeutic Advice and Information Service (TAIS) – a medicines information service staffed by specialist drug information pharmacists – on 1300 138 677 Monday to Friday 9am-7pm Eastern Standard Time for the cost of a local call (mobiles may cost more).

ENDS

Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published by the National Prescribing Service Limited (NPS), an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing. Australian Prescriber is distributed every two months in hard copy to health professionals, free of charge, and online in full text at www.australianprescriber.com.