• Note: Doses are NOT interchangeable with other botulinum toxin products.

Blepharospasm

• IM (Adults ): Treatment naive: 25 units/eye consisting of 6 injections (lateral and medial superior pretarsal part of orbicularis oculi muscle, lateral canthus of orbicularis oculi muscle, inferolateral portion of orbicularis oculi muscle, and corrugator muscle). Not to be repeated more frequently than every 3 mo. Previously treated with a botulinum toxin A: Consider previous dose, response to treatment, duration of response, and history of adverse events when determining dose of incobotulinum toxin A. Do not exceed dose of 50 units/eye. Not to be repeated more frequently than every 3 mo.

Cervical Dystonia

• IM (Adults ): 120 units total/treatment session; dose, number, and location based on number and location of involved sites. Not to be repeated more frequently than every 3 mo.

Upper Facial Lines

• Glabellar Lines
• IM (Adults ): 20 units/session consisting of 5 injections (2 in each corrugator muscle, 1 in the procerus muscle) of 4 units apiece. Not to be repeated more frequently than every 3 mo.
• Horizontal Forehead Lines
• IM (Adults ): 20 units/session consisting of 5 horizontally orientated injection sites into the frontalis muscle of 4 units apiece. Should be administered in combination with glabellar line injections to minimize brow ptosis. Not to be repeated more frequently than every 3 mo.
• Lateral Canthar Lines
• IM (Adults ): 24 units/session consisting of 6 injections (3 injection sites per side in the lateral orbicularis oculi muscle) of 4 units apiece. Not to be repeated more frequently than every 3 mo.

Upper Limb Spasticity

• IM (Adults ): Brachioradialis: 25–100 units divided in 1–3 sites; not more frequently than every 3 mo; Biceps: 50–200 units divided in 1–4 sites; not more frequently than every 3 mo; Brachialis: 25–100 units divided in 1–2 sites; not more frequently than every 3 moFlexor carpi radialis or flexor carpi ulnaris: 25–100 units divided in 1–2 sites; not more frequently than every 3 mo; Flexor digitorum profundus or flexor digitorum superficialis: 25–100 units divided in 2 sites; not more frequently than every 3 mo; Pronator quadratus: 10–50 units in 1 site; not more frequently than every 3 mo; Pronator teres: 25–75 units divided in 1–2 sites; not more frequently than every 3 mo;Flexor pollicis longus: 10–50 units in 1 site; not more frequently than every 3 mo; Adductor pollicis, flexor pollicis brevis: 5–30 units in 1 site; not more frequently than every 3 mo.
• IM (Children ≥2 yr): 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 200 units/upper limb [400 units if both upper limbs treated]): Flexor carpi radialis: 1 unit/kg/upper limb in 1 site (max dose = 25 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Flexor carpi ulnaris: 1 unit/kg/upper limb in 1 site (max dose = 25 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Flexor digitorum profundus: 1 unit/kg/upper limb in 1 site (max dose = 25 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Flexor digitorum superficialis: 1 unit/kg/upper limb in 1 site (max dose = 25 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Brachialis: 1–2 units/kg/upper limb divided in 1–2 sites (max dose = 50 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Brachioradialis: 1–2 units/kg/upper limb divided in 1–2 sites (max dose = 50 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Biceps: 2–3 units/kg/upper limb divided in 1–3 sites (max dose = 75 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Pronator teres: 1–2 units/kg/upper limb divided in 1–2 sites (max dose = 50 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Pronator quadratus: 0.5 units/kg/upper limb in 1 site (max dose = 12.5 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Flexor pollicis longus: 1 unit/kg/upper limb in 1 site (max dose = 25 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Adductor pollicis: 0.5 units/kg/upper limb in 1 site (max dose = 12.5 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms; Flexor pollicis brevis/opponens pollicis: 0.5 units/kg/upper limb in 1 site (max dose = 12.5 units/upper limb); may be repeated every 12–16 wk, based on return of symptoms.

Chronic Sialorrhea

• Intrasalivary(Adults ): 30 units injected into parotid gland on each side (60 units total) and 20 units injected into submandibular gland on each side (40 units total). Not to be repeated more frequently than every 4 mo.
• Intrasalivary(Children ≥2 yr and ≥30 kg): 22.5 units injected into parotid gland on each side (45 units total) and 15 units injected into submandibular gland on each side (30 units total). Not to be repeated more frequently than every 4 mo.
• Intrasalivary(Children ≥2 yr and 27–<30 kg): 18 units injected into parotid gland on each side (36 units total) and 12 units injected into submandibular gland on each side (24 units total). Not to be repeated more frequently than every 4 mo.
• Intrasalivary(Children ≥2 yr and 23–<27 kg): 15 units injected into parotid gland on each side (30 units total) and 10 units injected into submandibular gland on each side (20 units total). Not to be repeated more frequently than every 4 mo.
• Intrasalivary(Children ≥2 yr and 19–<23 kg): 12 units injected into parotid gland on each side (24 units total) and 8 units injected into submandibular gland on each side (16 units total). Not to be repeated more frequently than every 4 mo.
• Intrasalivary(Children ≥2 yr and 15–<19 kg): 9 units injected into parotid gland on each side (18 units total) and 6 units injected into submandibular gland on each side (12 units total). Not to be repeated more frequently than every 4 mo.
• Intrasalivary(Children ≥2 yr and 12–<15 kg): 6 units injected into parotid gland on each side (12 units total) and 4 units injected into submandibular gland on each side (8 units total). Not to be repeated more frequently than every 4 mo.