Brand Name: Botox
Generic Name: onabotulinumtoxinA

Medication Class: Botulinum toxin, Neuromuscular toxin
Manufacturer: Allergan, Inc
Approval date: December 1991

What is Botox and how does it work

Botox is an injectable neurotoxin that blocks neuromuscular transmission, the ability of nerves to make muscles contract, by decreasing the release of acetylcholine. In other words, it paralyzes the muscles. It is produced by the bacterium Clostridium botulinum.

What does Botox treat?

• Cervical dystonia: Muscular spasms in the neck and abnormal head positions
• Blepharospasm: Uncontrollable blinking
• Strabismus: Misaligned or lazy eyes/ squints
• Axillary hyperhidrosis: Excessive armpit sweating
• Chronic migraine
• Upper limb spasticity
• Treatment of urinary incontinence due to neurologic conditions (e.g., multiple sclerosis, spinal cord injury

How effective is Botox?

• Cervical Dystonia: Benefits are evident by 6 weeks but return to baseline by 3 months following injection.
• Blepharospasm: Effect last about 12 weeks and can be seen as early as 48 hours after injection.
• Axillary hyperhidrosis: Four weeks after injection 91% of patients that received Botox injection showed 50% improvement in armpit sweating compared to 36% percent of patients that received placebo.
• Chronic migraine: In one study patients that received Botox experienced on average approximately 2 fewer days of the headache than those that received placebo.
• Upper limb spasticity: 90, 180, or 360 units of Botox significantly improved limb spasticity compared to placebo after 6-weeks. 
• Urinary incontinence: 200 units of Botox reduced the weekly frequency of urinary incontinence more than placebo after 6-weeks of treatment. The difference was approximately 9 few episodes. 

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