It appears as a lyophilized white powder for injection in a colorless transparent vial.
Indication and Usage
1. NEURONOX® is indicated for the treatment of benign essential blepharospasm in patients 18 years of age and
2. NEURONOX® is indicated for the treatment of equinus foot deformity due to spasticity in pediatric
cerebral palsy patients 2 years of age and older.
3. Temporary improvement of serious glabellar wrinkles ranging from moderate to severe associated with
corrugators muscle and/or procerus muscle activities in adults over the age of 20 and below the age of 65.
4. Muscle spasticity : NEURONOX® is indicated for the treatment of upper limb spasticity associated with
stroke in patient 20 years of age and older.
Dosage and Administration
For blepharospasm, reconstituted NEURONOX® (see Dilution Table) is injected using a sterile, 27 – 30
gauge needle without electromyographic guidance. The initial recommended dose is 1.25 – 2.5 U (0.05 mL
to 0.1 mL volume at each site) injected into the medial and lateral pre-tarsal orbicularis oculi of the
upper lid and into the lateral pre-tarsal orbicularis oculi of the lower lid. In general, the initial effect of
the injections is seen within three days and reaches a peak at one to two weeks post-treatment. Each treatment lasts
appro xi mately th ree month s, fol low ing whic h the procedu re can be repeated. At repe at
treatment sessions, the dose may be increased up to two-fold if the response from the initial treatment is considered
insufficient-usually defined as an effect that does not last longer than two months.
there appears to be little benefit obtainable from injecting more than 5.0 U per site. Some tolerance may be found
when the drug is used in treating blepharospasm if treatments are given any more frequently
than every three months, and is rare to have the effect be permanent.
The cumulative dose of NEURONOX® treatment in a 30-day period should not exceed 200 U.