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Myobloc
Myobloc, also known by its generic name rimabotulinumtoxinB, is a neurotoxin used to treat cervical dystonia (a condition that causes abnormal muscle contractions and neck pain). It is also sometimes used for sialorrhea (excessive drooling). Myobloc belongs to a class of drugs called botulinum toxins, which work by blocking nerve signals to muscles, temporarily reducing muscle activity and providing relief from abnormal movements or spasms. Myobloc is injected into the affected muscles by a healthcare provider.
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Frequently Asked Questions
How long does it take for Myobloc to start working?
The effects of Myobloc typically begin within 7 to 14 days after the injection. The maximum benefit may be seen after several weeks.
How long do the effects of Myobloc last?
The effects of Myobloc generally last 12 to 16 weeks, after which repeat injections may be necessary to maintain the benefits.
Can Myobloc spread to other parts of the body?
Yes, in rare cases, Myobloc may spread beyond the injection site and cause muscle weakness in other areas of the body. This is why it’s important to monitor for symptoms like difficulty swallowing or breathing after receiving the injection.
What should I do if I experience severe side effects after receiving Myobloc?
If you experience serious side effects such as difficulty breathing, swallowing, or muscle weakness in areas distant from the injection site, seek immediate medical attention.
Can I receive other botulinum toxin products if I am being treated with Myobloc?
It’s important to avoid using other botulinum toxin products while being treated with Myobloc, as combining them can increase the risk of side effects. Always inform your healthcare provider about any other treatments you are receiving.
Comprehensive Drug Guide
How Does Myobloc Work?
Myobloc works by blocking the release of acetylcholine, a neurotransmitter responsible for sending signals between nerves and muscles. By inhibiting acetylcholine release, Myobloc temporarily paralyzes or weakens the overactive muscles, reducing muscle spasms and abnormal movements in conditions like cervical dystonia. In the case of sialorrhea, it decreases the activity of salivary glands, reducing excessive drooling.
Common Dosages
- 2,500 units/mL
- 5,000 units/mL
- 10,000 units/mL
Typical Dosing
- For cervical dystonia, the typical dose varies depending on the patient’s condition and muscle size, but it commonly ranges from 2,500 to 5,000 units injected into affected muscles. The dose can be adjusted based on the patient’s response, and injections are typically repeated every 12 to 16 weeks.
- For sialorrhea, doses usually range from 1,500 to 3,500 units injected into the salivary glands.
Typical Dosing
FDA Approved Indications
- Cervical dystonia to reduce the severity of abnormal head position and neck pain in adults.
- Chronic sialorrhea (excessive drooling) in adults.
Who Shouldn't Take Myobloc?
- A known allergy or hypersensitivity to botulinum toxin or any of the ingredients in the formulation.
- A history of infection at the injection site.
- Conditions that interfere with neuromuscular function, such as myasthenia gravis or amyotrophic lateral sclerosis (ALS).
Advice From The Pharmacist
- Myobloc is administered by a healthcare provider, so ensure you follow their instructions regarding follow-up appointments and monitoring.
- After receiving Myobloc, avoid rubbing or massaging the injection site to prevent the toxin from spreading to unintended areas.
- Inform your healthcare provider if you experience any difficulty swallowing, speaking, or breathing, as these may be signs of botulinum toxin spreading beyond the injection site.
- Discuss any other medications or supplements you are taking with your doctor, as certain drugs may increase the risk of side effects or interact with Myobloc.
- If you're being treated for sialorrhea, make sure to drink plenty of fluids to prevent dehydration due to reduced saliva production.
Side Effects of Myobloc
Common Side Effects
- Dry mouth
- Difficulty swallowing (dysphagia)
- Headache
- Injection site pain
- Flu-like symptoms
Uncommon/Severe Side Effects
- Difficulty breathing or swallowing
- Muscle weakness in areas distant from the injection site
- Severe allergic reactions (rash, swelling, itching, difficulty breathing)
- Vision changes or drooping eyelids
Risks and Warnings of Myobloc
- Spread of Toxin Effects: Myobloc may cause side effects due to the toxin spreading beyond the injection site. This can result in muscle weakness, difficulty swallowing, or breathing issues. In rare cases, these symptoms may occur weeks after the injection.
- Respiratory Complications: Patients with pre-existing respiratory conditions or those who receive higher doses of Myobloc may be at higher risk of developing breathing difficulties. Close monitoring is required, especially in patients with neuromuscular disorders.
- Hypersensitivity Reactions: In rare cases, patients may experience serious allergic reactions, including anaphylaxis. Immediate medical attention is necessary if symptoms of a severe allergic reaction occur.
Interactions with Myobloc
Common Drug Interactions
- Aminoglycoside antibiotics (e.g., gentamicin) may increase the effects of Myobloc, leading to more pronounced muscle weakness.
- Muscle relaxants (e.g., baclofen) can enhance the muscle-weakening effects of Myobloc.
- Other botulinum toxin products: Concurrent use of other botulinum toxin injections (like Botox) should be avoided to reduce the risk of toxin spread and increased side effects.
Alternatives to Myobloc
- Botox (onabotulinumtoxinA): Another botulinum toxin used for cervical dystonia and chronic sialorrhea.
- Dysport (abobotulinumtoxinA): A similar botulinum toxin used for treating cervical dystonia and other conditions.
- Xeomin (incobotulinumtoxinA): A botulinum toxin alternative used for the same indications as Myobloc, including muscle spasms and sialorrhea.
