What is Xeomin?
Xeomin is a muscle-relaxing medicine that is formulated and manufactured by Merz Pharma, an international company specialising in producing medical products such as neurology and dermatology. This neuromuscular paralytic medicine is made of the botulinum neurotoxin type A that is extracted and purified from Clostridium botulinum bacteria cultures. The sterilised muscle-relaxant comes in the form of a white powder that must be reconstituted with 9mg/mL (0.9%) sodium chloride solution before it can be administered intramuscularly. The reconstituted solution should transparent, colourless, and free from any suspending particles. The powder is packaged in a vial that must be stored at a temperature below 25℃, while the reconstituted solution must be used immediately following preparation. Xeomin is marketed as Bocouture in some countries.
What is Xeomin used for?
Clostridium botulinum is a gram-positive bacterium that is found in ample quantities in environmental settings like lakes and ponds. The neurotoxin is now used extensively in the medical industry due to its excellent neuromodulating actions. Xeomin is formulated to address various disorders caused by uncontrollable muscle spasms, such as twisted neck (spasmodic torticollis), eyelid spasms (blepharospasm), and stiff muscles in the limbs after a stroke (post-stroke spasticity).
What is the dose requirement for Xeomin?
The optimum dosing, frequency, and number of Xeomin injection sites vary on an individual basis. These will vary depending on the patient’s age and health condition.
- Twisted Neck (Spasmodic Torticollis): The management of twisted neck using Xeomin must be tailored according to the patient’s head and neck position, location of pain, body weight, muscle hypertrophy, and response to the toxin solution injection. Nevertheless, no more than 200 units of the toxin should be injected during the initial therapy session. Also, medical practitioners should only inject less than 50 units at any 1 injection site.
- Eyelid Spasm (Blepharospasm): The initial recommended dose is 1.25 to 2.5 units per injection site while not exceeding 25 units of toxin in each eye. Physicians must also ensure that they are not injecting more than 100 units every 12 weeks.
- Post-Stroke Limb Spasticity: The exact dose of Xeomin for correcting post-stroke limb spasticity must be personalised according to the number, size, and location of the affected muscles; the severity of the muscle spasticity; and the presence of local muscle weakness. Nevertheless, the maximum total dose of the toxin solution to treat upper limb spasticity must be capped at 500 units per treatment session. As well, specialists must ensure that they are administering less than 250 units of toxin to the shoulder muscles.
Only certified medical practitioners who are experienced with the preparation and administration of botulinum toxin should conduct the procedure.
Patients may experience localised reactions caused by the minimally-invasive injections such as pain, swelling, redness, bruising, and itching. These reactions are part of the skin recovery process and should subside within a week. On the other hand, patients may even experience other more serious aftereffects of toxin administration such as swallowing and breathing difficulties caused by excessive muscle relaxation. Other side effects are specific to the site of injection. Refer to the product pamphlet for a complete list of adverse reactions. Patients must be informed of the potential side effects, so they can recognise when they need additional medical attention.