Cervical Dystonia

• IM (Adults ): 500 units as a divided dose among affected muscles; may be repeated every 12–16 wk, based on return of symptoms (range 250 and 1000 units). Increments may be made in 250–unit steps according to response.

Glabellar Lines

• IM (Adults <65 yr): 50 units, divided in five equal aliquots of 10 units; may be repeated every 3 mo.

Upper Limb Spasticity

• IM (Adults ): 500–1000 units as a divided dose among affected muscles, with the following doses being used for each muscle: Flexor carpi radialis: 100–200 units; may be repeated every 12–16 wk, based on return of symptoms; Flexor carpi ulnaris: 100–200 units; may be repeated every 12–16 wk, based on return of symptoms; Flexor digitorum profundus: 100–200 units; may be repeated every 12–16 wk, based on return of symptoms; Flexor digitorum superficialis: 100–200 units; may be repeated every 12–16 wk, based on return of symptoms; Brachialis: 200–400 units; may be repeated every 12–16 wk, based on return of symptoms; Brachioradialis: 100–200 units; may be repeated every 12–16 wk, based on return of symptoms; Biceps brachii: 200–400 units; may be repeated every 12–16 wk, based on return of symptoms; Pronator teres: 100–200 units; may be repeated every 12–16 wk, based on return of symptoms.
• IM (Children ≥2 yr and ≥10 kg): 8–16 units/kg as a divided dose among affected muscles, with the following doses being used for each muscle (total dose should not exceed 640 units): Flexor carpi radialis: 2–4 units/kg/upper limb in up to 2 sites; may be repeated every 16–28 wk, based on return of symptoms; Flexor carpi ulnaris: 1.5–3 units/kg/upper limb in 1 site; may be repeated every 16–28 wk, based on return of symptoms; Flexor digitorum profundus: 1–2 units/kg/upper limb in 1 site; may be repeated every 16–28 wk, based on return of symptoms; Flexor digitorum superficialis: 1.5–3 units/kg/upper limb in up to 4 sites; may be repeated every 16–28 wk, based on return of symptoms; Brachialis: 3–6 units/kg/upper limb divided in up to 2 sites; may be repeated every 16–28 wk, based on return of symptoms; Brachioradialis: 1.5–3 units/kg/upper limb in 1 site; may be repeated every 16–28 wk, based on return of symptoms; Biceps brachii: 3–6 units/kg/upper limb divided in up to 2 sites; may be repeated every 16–28 wk, based on return of symptoms; Pronator teres: 1–2 units/kg/upper limb in 1 site; may be repeated every 16–28 wk, based on return of symptoms; Pronator quadratus: 0.5–1 units/kg/upper limb in 1 site; may be repeated every 16–28 wk, based on return of symptoms.

Lower Limb Spasticity

• IM (Adults ): 1000–1500 units as a divided dose among affected muscles, with the following doses being used for each muscle: Gastrocnemius (medial head): 100–150 units; Gastrocnemius muscle (lateral head): 100–150 units;Soleus: 330–500 units; Tibialis posterior: 200–300 units; Flexor digitorum longus: 130–200 units; Flexus hallucis longus: 70–200 units; may be repeated every 12–16 wk, based on return of symptoms.
• IM (Children ≥2 yr): 10–15 units/kg as a divided dose among affected muscles, with the following doses being used for each muscle: Gastrocnemius: 6–9 units/kg/leg divided in 4 sites; may be repeated after 3 mo, based on return of symptoms; Soleus: 4–6 units/kg/leg divided in 2 sites; may be repeated after 3 mo, based on return of symptoms.