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What is a Botox Injection Anyway?

The cosmetic form of botulinum toxin, as an orphan drug for the treatment of
often referred to by its product name strabismus, hemifacial spasms, and
Botox, is a popular non-surgical blepharospasm. BOTOX is distributed in
injection that temporarily reduces or 100-unit vials.The original batch of
eliminates frown lines, forehead creases, neurotoxin prepared by Shantz in November
crows feet near the eyes and thick bands 1979 (designated batch 79-11) constituted
in the neck. The toxin blocks the nerve the original BOTOX formulation and was
impulses, temporarily paralyzing the used until December 1997. It was replaced
muscles that cause wrinkles while giving by a new neurotoxin complex batch
the skin a smoother, more refreshed designated BCB 2024. The new bulk batch
appearance. Studies have also suggested is 5-6 times more potent on a weight
that Botox is effective in relieving basis. In a 100-unit vial, only 4.8 ng of
migraine headaches, excessive sweating neurotoxin is needed compared to 25 ng of
and muscle spasms in the neck and eyes. 79-11. The new BOTOX is comparable in
Botulinum neurotoxin is produced by the clinical efficacy and safety to the old,
gram-negative anaerobic bacterium and a unit dose of new BOTOX provides an
Clostridium botulinum. equivalent response to the same unit dose
Eight serologically distinct botulinum of old BOTOX. Hopefully, the reduced
neurotoxins exist, designated as A, B, protein load of the new BOTOX leads to
C1, C2, D, E, F, and G. Seven are reduced immunogenicity and a lower
associated with paralysis. Types A, B, E incidence of neutralizing antibody
and, rarely, F and G are associated with formation.Dysport is another formulation
human botulism.The dose of botulinum of botulinum toxin type A available in
toxin is expressed in mouse units. One Europe and a few other countries. It is
unit is equal to the amount that will prepared using column-based purification
kill 50% of a group of 18- to 22-g Swiss techniques and distributed in 500-unit
Webster mice when injected vials that can be stored at room
intraperitoneally. The human lethal dose temperature. BOTOX and Dysport are both
(LD) for BOTOX (botulinum type A purified botulinum toxin type A preparations but
neurotoxin complex) is estimated at are quite distinct from one another.
approximately 3000 units. BOTOX BOTOX is approximately 4 times more
injections of less than 100 units usually potent on a per unit basis, and Dysport
are used for cosmetic purposes and of doses often are approximately 4 times the
less than 300-600 units for other BOTOX doses used to generate a similar
purposes, thereby allowing a wide safety clinical effect. Differences in these
margin. Recognizing that doses are not toxins may relate to differences in the
interchangeable among different strain of bacterium, preparation,
formulations of botulinum toxin (BOTOX, diffusion, and potency testing.Myobloc is
Dysport, Myobloc) is important; to a botulinum toxin type B preparation
achieve similar clinical effects, currently in clinical trials. It is
different doses are used.BOTOX is a anticipated that it will be distributed
sterile lyophilized form of botulinum as a solution. Little information is
toxin type A. It is produced from a available concerning the cosmetic use of
culture of the Hall strain of C botulinum Dysport and Myobloc. The remainder of
and purified by a series of acid this article therefore focuses on BOTOX,
precipitations to a crystalline complex and all unit doses refer to BOTOX unless
containing the toxin and other proteins. otherwise specified.
The FDA approved BOTOX in December 1989




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