Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
botulinum toxin, Botox Cosmetic
Synonyms :
onabotulinumtoxinA
Class :
Neuromuscular Blocking agent, Botulinum Toxins
Brand Name :
botulinum toxin, Botox Cosmetic
Synonyms :
onabotulinumtoxinA
Class :
Neuromuscular Blocking agent, Botulinum Toxins
Dosage Forms & Strengths Â
Powder for reconstitution Â
50 units/vial  Â
100 units/vial Â
200 units/vial Â
Indicated for botulinum toxin for the treatment of strabismus depends on the size of the misalignment and the specific muscle being treated:
1.25-2.5 Units in any one muscle for vertical muscles and less than 20 prism diopters in any one muscle for horizontal strabismus.
The recommended dose for horizontal strabismus of 20-50 prism diopters is 2.5-5 Units in any one muscle.
1.25 and 2.5 Units in the medial rectus muscle for 1 month or more of persistent VI nerve palsy.
It is important to note that the recommended doses are only guidelines; the actual dose will vary depending on the individual patient and the circumstances.
Patients should be reexamined 7 to 14 days after each injection to determine the efficacy of the treatment and whether additional injections are required.
In patients who experienced incomplete paralysis of the target muscle, the dose may be increased up to twofold over the previous dose.
1.25-2.5 Units per injection site, with a maximum of 5 Units per site.
A cumulative dose of 200 Units in a 30-day period is generally not recommended.
If the response to treatment is deemed insufficient, the dose can be increased up to twofold, though injections more frequently than every three months may cause tolerance.
Note:
The treatment for blepharospasm often involves injecting small amounts of a medication called botulinum toxin into the muscles around the eye.
The injections are given into specific points around the eyelids called the pretarsal orbicularis oculi muscles.
The goal of the injections is to relax these muscles and reduce the frequency and severity of the contractions.
Dosage Forms & Strengths Â
Powder for reconstitution Â
50 units/vial  Â
100 units/vial Â
200 units/vial Â
1.25-2.5 Units in any one muscle for vertical muscles and less than 20 prism diopters in any one muscle for horizontal strabismus.
The recommended dose for horizontal strabismus of 20-50 prism diopters is 2.5-5 Units in any one muscle.
1.25 and 2.5 Units in the medial rectus muscle for 1 month or more of persistent VI nerve palsy.
It is important to note that the recommended doses are only guidelines; the actual dose will vary depending on the individual patient and the circumstances.
Patients should be reexamined 7 to 14 days after each injection to determine the efficacy of the treatment and whether additional injections are required.
In patients who experienced incomplete paralysis of the target muscle, the dose may be increased up to twofold over the previous dose.
1.25-2.5 Units per injection site, with a maximum of 5 Units per site.
A cumulative dose of 200 Units in a 30-day period is generally not recommended.
If the response to treatment is deemed insufficient, the dose can be increased up to twofold, though injections more frequently than every three months may cause tolerance.
Note:
The treatment for blepharospasm often involves injecting small amounts of a medication called botulinum toxin into the muscles around the eye.
The injections are given into specific points around the eyelids called the pretarsal orbicularis oculi muscles.
The goal of the injections is to relax these muscles and reduce the frequency and severity of the contractions.
Refer to adult dosingÂ
may have an increased adverse neuromuscular effect when combined with corticosteroids
may have an increased adverse neuromuscular effect when combined with corticosteroids
may have an increased adverse neuromuscular effect when combined with corticosteroids
may have an increased adverse neuromuscular effect when combined with corticosteroids
may have an increased adverse neuromuscular effect when combined with corticosteroids
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may diminish the rate of excretion which results in higher serum level
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increased arrhythmogenic effect when combined with cardiac glycosides
may have an increasingly adverse effect when combined with products containing botulinum toxin
may have an increased the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased therapeutic effect when combined with neuromuscular-blocking agents
neomycin/polymyxin B/bacitracin topical
may have an increased therapeutic effect when combined with neuromuscular-blocking agents
may have an increased therapeutic effect when combined with neuromuscular-blocking agents
may have an increased therapeutic effect when combined with neuromuscular-blocking agents
may have an increased therapeutic effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
lansoprazole, amoxicillin, and clarithromycin
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may decrease the neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
benzoyl peroxide, clindamycin phosphate, adapaleneÂ
caution is recommended when using this medication in patients using other neuromuscular blocking agents, as the clindamycin in this medication enhances the neuromuscular blocking properties of other neuromuscular agents
may increase the respiratory depressant effect
due to the anticholinergic activity of diphenhydramine, the effects of anticholinergics (e.g., some psychotropic drugs and atropine) may be intensified, leading to symptoms such as dry mouth, gastrointestinal disturbances (e.g., colic), urinary retention, increased heart rate, and headache
May diminish the effects of pharmacodynamic antagonism
May diminish the effects of pharmacodynamic antagonism
May diminish the effects of pharmacodynamic antagonism
May diminish the effects of pharmacodynamic antagonism
Frequency Not Defined Â
>10%  Â
Residual urine volume (3-17%) Â
Urinary retention (17-18%) Â
Somnolence and sedation (16%) Â
Urinary tract infection (26-31%) Â
Dizziness (4-12%) Â
Urinary retention (6-15%) Â
1-10%  Â
Eyelid ptosis (2-3%) Â
Headache (9%) Â
Skin tightness (2%) Â
Muscular weakness (1%) Â
Brow ptosis (2%) Â
Eyelid edema (1%) Â
Facial paresis (1%) Â
1-10% Â
Dysuria (5-9%) Â
Neck pain (8-9%) Â
Bacteriuria (9%) Â
Headache (5%) Â
Eyelid ptosis (4%) Â
Migraine (4%) Â
Â
Pregnancy warnings:    Â
US FDA pregnancy category: N/AÂ
Lactation:  Â
Excreted into human milk is unknown Â
Pregnancy Categories:        Â
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    Â
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    Â
Category N: There is no data available for the drug under this categoryÂ
Patient information leafletÂ
Generic Name: onabotulinumtoxinAÂ
Why do we use onabotulinumtoxinA?Â
OnabotulinumtoxinA, also known as Botox, is a medication that is injected into muscles to treat various medical conditions. It is most commonly used to reduce the appearance of wrinkles and fine lines on the face, but it can also be used to treat other conditions such as excessive sweating, muscle spasms, and chronic migraines.Â
One of the main active ingredients in Botox is botulinum toxin, which is a neurotoxin produced by the bacterium Clostridium botulinum. When injected into a muscle, Botox works by blocking the release of a chemical called acetylcholine, which is involved in the transmission of nerve impulses to muscles. This prevents the muscle from contracting, causing it to relax.Â
In the case of wrinkle reduction, Botox is injected into the muscles that cause wrinkles, such as the forehead, between the eyebrows, and around the eyes. By relaxing these muscles, the skin appears smoother and more youthful. Botox treatments are generally considered safe when performed by a trained medical professional.Â
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