Benign Essential Blepharospasm Medication

  • Author: Robert H Graham, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Sep 2, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Botulinum toxins

Class Summary

Help produce symptomatic improvement of orbicularis spasm and autonomic symptoms.

The various botulinum toxins possess individual potencies and care is required to assure proper use and avoid medication errors. Recent changes to the established drug names by the FDA were intended to reinforce these differences and prevent medication errors. The products and their approved indications include:

  • OnabotulinumtoxinA (Botox, Botox Cosmetic)
    • Botox: cervical dystonia, severe primary axillary hyperhidrosis, strabismus, blepharospasm
    • Botox Cosmetic: moderate-to-severe glabellar lines
  • AbobotulinumtoxinA (Dysport): cervical dystonia, moderate-to-severe glabellar lines
  • IncobotulinumtoxinA (Xeomin): cervical dystonia, blepharospasm
  • Rimabotulinummtoxin B (Myobloc): cervical dystonia
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OnabotulinumtoxinA (BOTOX ®)

 

Treats excessive, abnormal contractions associated with blepharospasm. Binds to receptor sites on motor nerve terminals and inhibits release of ACh, which, in turn, inhibits transmission of impulses in neuromuscular tissue.

Reexamine patients 7-14 d after initial dose to assess for response. Increase doses 2-fold over previous dose for patients experiencing incomplete paralysis of target muscle. Do not exceed 25 U when giving it as single injection or 200 U as cumulative dose in 30-day period.

View full drug information

IncobotulinumtoxinA (Xeomin)

 

Botulinum toxin type A that is free of complexing proteins found in natural toxin from Clostridium botulinum. Acetylcholine release inhibitor and neuromuscular blocking agent. Indicated for blepharospasm in adults previously treated with onabotulinumtoxinA (Botox).

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Contributor Information and Disclosures
Author

Robert H Graham, MD  Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona

Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Arizona Ophthalmological Society

Disclosure: WebMD/eMedicine Salary Employment

Specialty Editor Board

Ron W Pelton, MD, PhD  Private Practice, Colorado Springs, Colorado

Ron W Pelton, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Society of Ophthalmic Plastic and Reconstructive Surgery, AO Foundation, and Colorado Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor, Stanley M Saulny, MD, to the development and writing of this article.

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