Myobloc (rimabotulinumtoxinB)

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Last reviewed · Source: First Databank (FDB) drug data

Overview

RimabotulinumtoxinB, a type B botulinum toxin produced by Clostridium botulinum, is a neuromuscular blocking agent and inhibitor of acetylcholine release at motor nerve terminals.

Botulinum toxin has been used for a wide variety of conditions in which the principal therapeutic aim is to reduce undesired or excessive contraction of striated or smooth (involuntary) muscle. There are 7 structurally similar botulinum toxin serotypes (A, B, C, D, E, F, and G) that differ antigenically and serologically. Currently in the US, there are 3 commercially available botulinum toxin type A preparations (abobotulinumtoxinA (Dysport(R)), incobotulinumtoxinA (Xeomin(R)), and onabotulinumtoxinA (Botox(R), Botox(R) Cosmetic)) and one botulinum toxin type B preparation (rimabotulinumtoxinB (Myobloc(R))).

Units of biologic activity of rimabotulinumtoxinB cannot be compared to or converted into units of any other botulinum toxin (e.g., abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA), and these preparations are not interchangeable. (See Cautions: Lack of Interchangeability Among Botulinum Toxin Preparations.)

Generic name: rimabotulinumtoxinB
Pronunciation: (BOT-ue-LYE-num)

Reference product & biosimilars

No reference, biosimilar or interchangeable associated with this drug.

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Indications

The following indications are listed for Myobloc:

  • Spasmodic Torticollis

Also known as: Cervical Dystonia, Dystonia Of Neck Muscles, Dystonic Torticollis, Rotatory Spasm, Rotatory Tic.

Dosing

Potency of rimabotulinumtoxinB is expressed in units of biologic activity; each unit is equivalent to the median intraperitoneal lethal dose (LD50) in mice. Because of differences in the drug vehicle, dilution scheme, and laboratory protocols for various mouse LD50 assays, units of biologic activity for rimabotulinumtoxinB (Myobloc(R)) cannot be compared with or converted to units of other botulinum toxins or any other toxin assessed with other specific assay methods.

Dosage of rimabotulinumtoxinB should be carefully individualized according to patient response. If a patient treated with rimabotulinumtoxinB fails to respond, clinicians should consider the possibility of an inadequate drug dose, incorrectly diluted and/or improperly stored drug solution, and/or misinjection.

Some clinicians suggest that the interval between rimabotulinumtoxinB injections should be as long as 8-12 weeks in patients receiving the drug for noncosmetic indications. In addition, it has been suggested that the possibility of antibody formation increases with higher doses and more frequent administration of rimabotulinumtoxinB. (See Cautions: Antibody Formation.)

Drug interactions

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Contraindications

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Adverse reactions

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Precautions

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ICD codes

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Formulary status

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Last reviewed · Source: First Databank (FDB) drug data