Botox - instructions for use, analogs, testimonials and release forms (injections in the form of lyophilizate) anti-wrinkle and cramps of the lips, forehead and other parts of the face. Pros and cons of drug administration in adults, as well as in pregnancy

In this article, you can read the instructions for using the drug Botox. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Botox in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Botox analogs in the presence of existing structural analogues. Use to treat wrinkles and spasms of the lips, forehead and other parts of the face in adults, as well as during pregnancy.

Botox - muscle relaxant.The botulinum toxin type A molecule consists of two chains: heavy (with a molecular weight of 100,000 Daltons) and light (with a molecular weight of 50,000 Daltons) connected by a disulfide bond.

The heavy chain has a high affinity for specific receptors localized on the surface of target neurons. The light chain is characterized by Zn2 + -dependent protease activity. It is specific for the cytoplasmic regions of the synaptosomal-linked protein with a molecular weight of 25,000 Daltons (SNAP-25), which takes part in exocytosis processes.

The first stage of the action of botulinum toxin type A is the specific binding of the molecule to the presynaptic membrane.

The second stage is the penetration of the bound toxin into the cytoplasm of neurons by endocytosis. Inside the cell, the light chain exhibits Zn2 + -dependent protease activity, selectively destroying SNAP-25, which in the third stage results in blockade of the release of acetylcholine from the presynaptic endings of the cholinergic neurons.

The end result is a prolonged chemodenervation.

Clinically, there is marked relaxation of the muscles in which the injection was made.In denervated muscles, the process of reinnervation occurs due to the formation of lateral processes of nerve endings 12 weeks after the injection, which leads to the restoration of muscle contractions. However, the shoots are partially effective and subsequently regress, while the primary neuromuscular transmission is activated. This requires a repetition of the correction procedure after a while and may be one of the drawbacks of using the drug.

Pharmacokinetics

The pharmacological effect of Botox develops at the injection site. It is proved that presynaptic seizure and retrograde axonal transport of the drug from the injection site is insignificant.

In therapeutic doses, Botox does not penetrate the BBB.

Antibodies to botulinum toxin type A can be formed after repeated injections in 1-5% of cases. The production of antibodies contributes to the administration of large doses of the drug, as well as repeated administration in small doses at short intervals (less than 14 days). When forming antibodies to botulinum toxin type A, the effect of its further use can be reduced.

Indications

• blepharospasm;
• hemifacial spasm;
• cervical dystonia (spasmodic torticollis);
• focal spasticity of the wrist and hand in patients who had a stroke;
• paralytic strabismus (strabismus);
• local muscular spasm in children's cerebral palsy in children aged 2 years and older;
• Correction of facial wrinkles.

Forms of release

Lyophilizate for the preparation of a solution for intramuscular injection of 100 units in a vial (flacon).

Instructions for use and ways of using the drug

The drug is administered intramuscularly. It is prepared by dissolving the powder of lyophilizate in ampoules, as it goes on sale. Has a number of restrictions when applying what will be reported further. The procedures are performed by a doctor who has a special permit from the manufacturer, since they require high qualification and should not be produced in artisanal conditions.

Side effects

• microhematomas (up to 7 days);
• pain at the injection site (up to 1 day);
• slight general weakness within 1 week (arise when the drug is used in doses exceeding the maximum allowable - more than 250 units);
• ptosis (omission) of the eyelids,
• the descent of the interbrow region, the lateral sections of the eyebrows
• disruption of accommodation
• asymmetry of the corners of the mouth
• violation of articulation, numbness of the lips.

As a rule, these side effects do not require additional therapy and regress within 1 month after the injection.

Complications after the injection are extremely rare and may occur if the needle is injured nerves or vessels in the case of unskilled procedure. Complications in the form of anaphylaxis are not described, nevertheless, during the injection, it is necessary to have means for urgent relief of anaphylactic reactions.

Contraindications

Are common:

• proven hypersensitivity to any component of the drug;
• inflammatory process at the site of the proposed injection (injection);
• acute phase of infectious diseases;
• pregnancy;
• lactation.

For blepharospasm and correction of facial muscles:

• pronounced gravitational ptosis of facial tissues;
• expressed "hernia" in the upper and lower eyelids.

Drug Interactions

The effect of Botox is enhanced by the simultaneous use of antibiotics of the group of aminoglycosides, erythromycin, tetracycline, lincomycin, polymyxins; drugs that reduce neuromuscular transmission (including curare-like muscle relaxants).

Application in pregnancy and lactation

Botox is contraindicated in pregnancy and lactation.

Impact on the ability to drive vehicles and manage mechanisms

Botox can lead to asthenia, muscle weakness, dizziness and visual disturbances. If such symptoms develop, there may be a danger in driving or working with moving machinery.

Botox analogues

Structural analogs for the active substance:

• Dysport
• Xeomin
• Lantox
• Relatox

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