Botox is used to smooth wrinkles and treat or prevent certain medical conditions, such as chronic migraines, severe underarm sweating, overactive bladder, strabismus, and muscle spasticity.

• Effects typically last for 3 to 4 months.
• Botox has a well-established safety profile when administered by a licensed provider.
• FDA-approved.

Botox Injection Uses

Botox Cosmetic is FDA-approved for use in Appearance Medicine for:

• Frown lines
• Crow’s feet
• Forehead wrinkles
• Neck bands

It may also be used off-label for bunny lines and jaw slimming .

Botox Therapeutic is FDA-approved for the following medical conditions:

• Overactive bladder (OAB) and urinary incontinence
• Chronic migraine prevention (15+ headache days/month)
• Muscle spasticity in adults and children 2+
• Cervical dystonia (neck muscle spasms)
• Severe underarm sweating (axillary hyperhidrosis)
• Eye conditions: blepharospasm, strabismus
• Neurogenic detrusor overactivity in children 5+.

Important Note: Although these formulations contain the same active ingredient, they are not interchangeable.

Pharmacist Tip

To ensure your Botox treatment is safe and effective, always get your injections from a licensed healthcare professional. This protects you from counterfeit Botox and minimizes side effect risks.

Results

Before and After Botox Cosmetic

What to Expect During Botox Treatment

Botox injections typically take just 10-30 minutes in your doctor’s office.

• Most people describe the sensation as a slight pinch, with minimal discomfort and no downtime.
• You’ll see initial results within 3-7 days, with full effects visible at 2 weeks.

How Much Does Botox Cost?

Botox Cosmetic treatments typically cost $300-$600 per treatment area and are not usually covered by insurance.

Botox Medical treatments are often covered by insurance when medically necessary for conditions like chronic migraine, overactive bladder, or cervical dystonia. Prior authorization may be required.

Financial support can be provided by AbbVie Patient Access Support in certain circumstances. 

Primary Medical Uses

• Overactive bladder (OAB) and urinary incontinence
• Chronic migraine prevention (15+ headache days/month)
• Muscle spasticity in adults and children 2+
• Cervical dystonia (neck muscle spasms)
• Severe underarm sweating (axillary hyperhidrosis)
• Eye conditions: blepharospasm, strabismus
• Neurogenic detrusor overactivity in children 5+

Primary Cosmetic Uses

• Frown lines (glabellar lines)
• Crow’s feet (lateral canthal lines)
• Forehead wrinkles
• Neck bands (platysma bands)

How Does Botox Work?

Botox (onabotulinumtoxinA) works by temporarily blocking nerve signals to muscles or sweat glands, relaxing them and providing cosmetic improvement for facial wrinkles and lines, and therapeutic relief from certain medical conditions.

For Medical Conditions:

• Relaxes overactive muscles (spasticity, dystonia)
• Improves bladder capacity (overactive bladder)
• Prevents migraine headaches (chronic migraine)
• Reduces excessive sweating (hyperhidrosis)
• Corrects eye alignment (strabismus)
• Controls muscle spasms (blepharospasm).

For Cosmetic Enhancement:

• Smooths forehead lines and crow’s feet
• Reduces frown lines between eyebrows
• Softens neck bands (platysma)
• Creates a refreshed, youthful appearance.

Side Effects

Common Side Effects

The most common side effects of Botox are:

• Mild injection site reactions (slight bruising, tenderness)
• Temporary headache 
• Mild fatigue.

These typically resolve within 24-48 hours.

Medical Use Specific Side Effects

Bladder Treatment:

• Urinary tract infections
• Painful urination
• Incomplete bladder emptying (may require temporary catheterization)
• Blood/bacteria in urine (pediatric patients).

Eye Treatment:

• Double vision or blurred vision
• Drooping eyelids (ptosis)
• Decreased eyesight
• Dry eyes
• Eyelid swelling

Serious Side Effects & Important Safety Information

Botox carries a Boxed Warning for distant spread of toxin effect.

Distant Spread of Toxin Effects (Boxed Warning)

Life-threatening botulism-like symptoms can rarely occur when onabotulinumtoxinA spreads away from the injection site. Seek urgent medical attention if you experience:

• Muscle weakness throughout the body
• Difficulty breathing or swallowing
• Vision problems: double vision, drooping eyelids
• Speech difficulties (dysarthria)
• Voice changes (dysphonia)
• Loss of bladder control.

Respiratory & Swallowing Problems

Respiratory and swallowing problems can occur hours to weeks after a Botox injection. People with pre-existing breathing/swallowing problems are at a higher risk. Severe cases may require a feeding tube, and rarely, death may occur if there are severe complications.

Allergic Reactions

Allergic reactions may happen with Botox. Seek immediate medical attention if you develop:

• Itching, rash, hives
• Wheezing or asthma symptoms
• Dizziness or fainting.

Tell your healthcare provider if you have any side effects that bother you or do not go away. These are not all the possible side effects of Botox. For more information, ask your doctor or pharmacist. Call your healthcare provider for medical advice about side effects.

Before Receiving

Absolute Contraindications

Do NOT receive Botox if you have:

• An allergy to onabotulinumtoxinA or the other ingredients in Botox Cosmetic or Botox Therapeutic
• An active skin infection at the injection site
• A previous allergic reaction to other botulinum products such as:
  • Dysport (abobotulinumtoxinA)
  • Xeomin (incobotulinumtoxinA)
  • Myobloc (rimabotulinumtoxin B)
  • Jeuveau (prabotulinumtoxinA-xvfs)
  • Daxxify (daxibotulinumtoxinA-lanm)
  • Letybo (letibotulinumtoxinA-wlbg).

Caution Needed

Tell your healthcare provider about all your medical conditions, including if you have:

• Neuromuscular disorders: ALS, myasthenia gravis, Lambert-Eaton syndrome
• Breathing problems: asthma, emphysema
• Swallowing difficulties
• Bleeding disorders
• Planned surgery or recent facial surgery
• Drooping eyelids or facial asymmetry
• Pregnancy plans. It is not known if Botox or Botox Cosmetic can harm your unborn baby
• Breastfeeding plans. It is not known if Botox or Botox Cosmetic passes into breastmilk.

How is Botox Administered?

Before Treatment

You’ll meet with a certified provider for a consultation. They’ll review your medical history, check for allergies, evaluate the treatment area, and go over the consent process and what to expect.

During Treatment

Your provider will clean the injection sites and administer Botox using very fine needles. The process takes 5 to 30 minutes, depending on the treatment area. Discomfort is minimal, and anesthesia typically isn’t needed.

After Treatment

Don’t rub the injection sites. Stay upright for 4 hours. Avoid exercise and facial treatments for 24 hours. Your provider will schedule a follow-up as needed.

Results Timeline

Initial effects start within 24 to 48 hours. Noticeable improvement appears in 3 to 7 days. Results peak at 2 weeks and gradually wear off over 3 to 6 months. Repeat treatments can be done as needed, with at least 3 months between sessions.

Age Restrictions

Botox is not approved for those aged:

• <18 years with urinary incontinence, chronic migraine, or overactive bladder 
• <18 years for cosmetic purposes
• <5 years with NDO
• <16 years with cervical dystonia
• <12 years with strabismus or blepharospasm
• <2 years with spasticity.

Botox for Medical Use Has Not Been Established For:

• Episodic migraine (≤14 days/month)
• Severe sweating anywhere other than your armpits.

What should I avoid while receiving Botox?

Botox may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of receiving the injection. If this happens, do not drive a car, operate machinery, or do other dangerous activities.

Avoid exercise and facial treatments for 24 hours.

Botox Cosmetic FDA Approvals: Dosing Information

Frown Lines (Glabellar Lines)

• Dosage: 20 Units (5 injection sites)
• Target: Corrugator and procerus muscles
• Results: Smoother forehead appearance

Crow’s Feet (Lateral Canthal Lines)

• Dosage: 24 Units (6 injection sites total)
• Target: Orbicularis oculi muscle
• Results: Reduced eye wrinkles

Forehead Lines

• Dosage: 40 Units total (5 injection sites forehead + 5 injection sites glabellar)
• Target: Frontalis muscle
• Results: Smoother forehead wrinkles

Platysma Bands (Neck Bands)

• Dosage: 26-36 Units total (18-28 injection sites)
• Target: Platysma muscle
• Results: Reduced vertical neck banding

Off-Label Cosmetic Uses

While not FDA-approved, common uses include:

• Lip lines (perioral wrinkles)
• Bunny lines (nasal wrinkles)
• Masseter Botox (jawline slimming)
• Gummy smile correction.

Botox Medical FDA Approvals: Dosing Information

Overactive Bladder (OAB) Treatment

• Indication: Adults with inadequate response to anticholinergics
• Dosage: 100 Units (5 units across 20 injection sites)
• Benefits: Reduces urgency, frequency, and incontinence

Neurogenic Detrusor Overactivity

• Adult dosage: 200 Units (6-7 units across 30 injection sites)
• Pediatric dosage (≥5 years): Weight-based dosing
• Conditions: Spinal cord injury, multiple sclerosis

Chronic Migraine Prevention

• Indication: Adults with 15+ headache days/month
• Dosage: 155 Units divided among 7 head/neck muscles
• Injection sites: 31 sites total
• Effectiveness: Reduces migraine frequency and severity
• Not approved for episodic migraine (≤14 days/month)

Muscle Spasticity Treatment

• Adult upper limb: Up to 400 Units
• Adult lower limb: 300-400 Units
• Pediatric spasticity (≥2 years): 3-8 Units/kg
• Conditions: Post-stroke, cerebral palsy, brain injury

Cervical Dystonia (Torticollis)

• Average dose: 198-300 Units split between affected muscles
• Benefits: Reduces abnormal head position and neck pain
• Duration: 3-4 months between treatments

Severe Axillary Hyperhidrosis

• Dosage: 50 Units per armpit (split over 10 to 20 sites per armpit)
• Indication: Inadequate response to topical treatments
• Effectiveness: Significantly reduces underarm sweating
• Not approved for severe sweating anywhere other than your armpits.

Eye Conditions

Blepharospasm (Eyelid Spasms)

• Dosage: 1.25-2.5 Units per site (3 sites per eye)
• Age: Adults and children 12+

Strabismus (Crossed Eyes)

• Dosage: Dosage varies based on prism diopter correction or previous response.
• Age: Adults and children 12+

Botox vs. Other Treatments

What other drugs affect Botox?

Tell your doctor about all your medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past. Especially tell your doctor if you:

• Have received any other botulinum toxin product in the last four months
• Have received injections of botulinum toxin, such as Myobloc (rimabotulinumtoxinB), Dysport (abobotulinumtoxinA), Xeomin (incobotulinumtoxinA), Jeuveau (prabotulinumtoxinA-xvfs), Daxxify (daxibotulinumtoxinA-lanm), or Letybo (letibotulinumtoxinA-wlbg) in the past. This may not be a complete list of all botulinum toxin products. Be sure your doctor knows exactly which product you received
• Have recently received an antibiotic by injection
• Take muscle relaxants
• Take an allergy or cold medicine
• Take a sleep medicine
• Take antiplatelets (aspirin-like products) or anti-coagulants (blood thinners).

Ask your doctor if you are not sure if your medicine is listed above. Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine.

Ingredients

Botox Therapeutic Ingredients

Active ingredient: onabotulinumtoxinA

Inactive ingredients: human albumin and sodium chloride.

Available as 100 Units or 200 Units as a vacuum-dried powder in a single-dose vial.

Botox Cosmetic Ingredients

Active ingredient: onabotulinumtoxinA

Inactive ingredients: human albumin and sodium chloride.

Available as 50 Units or 100 Units in a vacuum-dried powder in a single-dose vial for reconstitution.

Manufacturer

Botox is made by AbbVie, which acquired the previous manufacturer, Allergan, in 2020. AbbVie is headquartered in North Chicago, Illinois, USA.

Common Questions About Botox

What is Botox?

Botox is a cosmetic treatment used to reduce the appearance of facial wrinkles and treat medical conditions like migraines and excessive sweating.

How much does Botox cost?

The price varies, but most providers charge between $10 and $25 per unit. A typical session costs between $300 and $600, depending on the area being treated.

How long does Botox last?

Results typically appear within 1 to 2 weeks and last about 3 to 4 months, though this can vary.

What are the side effects of Botox?

Common side effects include mild bruising or redness. Serious side effects are rare but may include drooping eyelids or difficulty swallowing.

Will I look frozen or unnatural?

When properly administered by a skilled provider, Botox provides natural-looking results while maintaining facial expression

Can I get Botox while pregnant?

Safety in pregnancy is unknown; discuss with your healthcare provider.

Botox Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There are 2 for Botox.Botox (onabotulinumtoxinA) – AbbVie Inc.

Botox C

Baclofen belongs to a class of medications called skeletal muscle relaxants. Baclofen is an antispasmodic agent that acts on spinal cord nerves and decreases the number and severity of muscle spasms in patients with certain conditions affecting the spinal cord.

Baclofen is used in adults and children at least 12 years old to treat certain types of spasticity (muscle stiffness and tightness) and muscle pain in people with multiple sclerosis or a spinal cord injury or other spinal cord diseases.

Baclofen relieves pain and improves muscle movement.

Warnings

Do not use baclofen at a time when you need muscle tone for safe balance and movement during certain activities. Baclofen may make you drowsy. Do not drive or operate heavy machinery until you know how this medicine affects you.

Do not stop using this medicine suddenly, or you could have unpleasant withdrawal symptoms.

Ask your doctor about the safe use of alcoholic beverages while you are taking baclofen. Alcohol can make the side effects from baclofen worse.

Before taking this medicine

You should not use this medicine if you are allergic to baclofen.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• mental illness or psychosis;
• epilepsy or other seizure disorder;
• problems with balance;
• cerebral palsy;
• Parkinson’s disease;
• schizophrenia or a confused state;
• high blood pressure, or fast heart rate;
• a rheumatic disease;
• a stroke or blood clot; or
• kidney disease.

Using baclofen may increase your risk of developing an ovarian cyst. Talk with your doctor about your own risk.

Tell your doctor if you are pregnant or plan to become pregnant, or breastfeeding or plan to breastfeed. If you take baclofen while pregnant or breastfeeding, withdrawal symptoms such as tremors, stiff muscles, or seizure may occur in the baby.

How should I take baclofen?

Take baclofen exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Shake the oral suspension (liquid).

Measure a dose with the supplied measuring device (not a kitchen spoon).

Shake and pour the entire oral granules packet to dissolve in your mouth or swallow whole at once, with or without liquids.

You may also mix the granules with liquids (milk, or apple juice) or soft food (apple sauce, yogurt, or pudding).

The oral granules can also be given through a feeding tube. Ask your doctor or pharmacist if you do not understand these instructions.

Call your doctor if your symptoms do not improve, or if they get worse.

You may have withdrawal symptoms if you stop using baclofen suddenly. Ask your doctor before stopping the medicine.

Store the oral suspension (liquid) at room temperature away from moisture and heat. Throw Fleqsuvy away after 2 months of first opening.

Store Ozobax in the refrigerator, do not freeze.

Dosing information

Usual Adult Dose for Spasticity:

Oral:
-Initial dose: The following gradually increasing dosage regimen is suggested, but should be adjusted to suit individual patient requirements: 5 mg orally 3 times a day for 3 days, then 10 mg orally 3 times a day for 3 days, then 15 mg orally 3 times a day for 3 days, then 20 mg orally 3 times a day for 3 days
-Maintenance dose: Should be individualized.
-Maximum dose: 80 mg/day (20 mg orally 4 times a day).

Usual Pediatric Dose for Spasticity:

12 years and older:
Oral:
-Initial dose: The following gradually increasing dosage regimen is suggested, but should be adjusted to suit individual patient requirements: 5 mg orally 3 times a day for 3 days, then 10 mg orally 3 times a day for 3 days, then 15 mg orally 3 times a day for 3 days, then 20 mg orally 3 times a day for 3 days
-Maintenance dose: Should be individualized.
-Maximum dose: 80 mg/day (20 mg orally 4 times a day)

Comments:
-The lowest dose compatible with an optimal response is recommended.
-Slowly withdraw therapy if benefits are not evident after a reasonable period.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include increasing drowsiness, dizziness, sleepiness, trouble focusing on objects, shallow breathing, seizure, or muscle weakness leading to loss of consciousness.

What should I avoid while taking baclofen?

Avoid drinking alcohol.

Avoid driving or hazardous activity until you know how baclofen will affect you. Your reactions could be impaired.

Do not share this medicine with another person, even if they have the same symptoms you have.

Baclofen side effects

Get emergency medical help if you have signs of an allergic reaction to baclofen: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Baclofen may cause serious side effects. Call your doctor at once if you have:

• severe drowsiness, breathing problems;
• confusion, hallucinations;
• muscle weakness, itching, tingling, or twitching in your hands, arms, feet, or legs; or
• fever.

What is Jeuveau?

Jeuveau is made from the bacteria that causes botulism. Botulinum toxin blocks nerve activity in the muscles.

Jeuveau is a prescription medicine used to temporarily lessen the appearance of facial wrinkles (frown lines) between the eyebrows) in adults.

It is not known if Jeuveau is safe and effective for use in children.

Warnings

The botulinum toxin contained in Jeuveau can spread to other body areas beyond where it was injected. This can cause serious life-threatening side effects.

Call your doctor at once if you have a hoarse voice, drooping eyelids, vision problems, severe eye irritation, severe muscle weakness, loss of bladder control, or trouble breathing, talking, or swallowing.

Before taking this medicine

You should not be treated with Jeuveau if you are allergic to prabotulinumtoxinA, or if:

• you have an infection in the area where the medicine will be injected; or
• you have ever had an allergic reaction to any product that contains botulinum toxin, such as Botox, Dysport, Myobloc, or Xeomin.

To make sure Jeuveau is safe for you, tell your doctor if you have:

• other botulinum toxin injections such as Dysport or Myobloc (especially in the last 4 months);
• amyotrophic lateral sclerosis (ALS, or “Lou Gehrig’s disease”);
• myasthenia gravis;
• Lambert-Eaton syndrome;
• a side effect after prior use of botulinum toxin;
• a breathing disorder such as asthma or emphysema;
• problems with swallowing;
• facial muscle weakness (droopy eyelids, weak forehead, trouble raising your eyebrows);
• bleeding problems;
• heart disease; or
• surgery (especially on your face).

Tell your doctor if you are pregnant or breastfeeding.

Jeuveau is made from donated human plasma and may contain viruses or other infectious agents. Donated plasma is tested and treated to reduce the risk of contamination, but there is still a small possibility it could transmit disease. Ask your doctor about any possible risk.

If you have a planned surgery, tell your surgeon ahead of time about when you last received Jeuveau.

How is Jeuveau given?

Jeuveau should be given only by a trained medical professional, even when used for cosmetic purposes.

This medicine is injected into a muscle by a healthcare provider. Jeuveau injections should be spaced at least 3 months apart.

The effects of a Jeuveau injection are temporary. Your symptoms may return completely within 3 months. After repeat injections, it may take less and less time before your symptoms return, especially if your body develops antibodies to the botulinum toxin.

Do not seek Jeuveau injections from more than one medical professional at a time. If you switch healthcare providers, tell your new provider how long it has been since your last botulinum toxin injection.

Using this medication more often than prescribed will not make it more effective and may result in serious side effects.

Dosing information

Usual Adult Dose for Glabellar Lines:

20 Units per treatment session divided into 5 equal IM injections of 4 Units each:
-Two injections in each corrugator muscle (one into inferomedial and one into superior middle)
-One injection in the procerus muscle

Retreatment should be administered no more frequently than every three months

Comments:
-The cumulative dose of botulinum toxin should be considered if other botulinum toxin products are or have been used for other indications.

Use: For the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity.

What happens if I miss a dose?

Since botulinum toxin has a temporary effect and is given at widely spaced intervals, missing a dose is not likely to be harmful.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may not appear right away, but can include muscle weakness, trouble swallowing, and weak or shallow breathing.

What should I avoid after receiving Jeuveau?

This medicine may cause muscle weakness, vision problems, or dizziness. These effects can occur within hours or weeks after you receive a Jeuveau injection.

Avoid driving or hazardous activity until you know how this medicine will affect you.

Jeuveau side effects

Get emergency medical help if you have signs of an allergic reaction to Jeuveau: hives, itching; wheezing, difficult breathing; feeling like you might pass out; swelling of your face, lips, tongue, or throat.

The botulinum toxin contained in Jeuveau can spread to other body areas beyond where it was injected. This has caused serious life-threatening side effects in some people receiving botulinum toxin injections, even for cosmetic purposes.

Call your doctor at once if you have any of these side effects (up to several hours or several weeks after an injection):

• unusual or severe muscle weakness (especially in a body area that was not injected with the medication);
• trouble breathing, talking, or swallowing;
• loss of bladder control;
• hoarse voice, drooping eyelids;
• vision changes, eye pain, severely dry or irritated eyes (your eyes may also be more sensitive to light); or
• chest pain or pressure, pain spreading to your jaw or shoulder, irregular heartbeats.

Common Jeuveau side effects may include:

• headache;
• drooping eyelids;
• increased white blood cell counts; or
• cold symptoms such as stuffy nose, sneezing, sore throat.

What is methocarbamol?

Methocarbamol is a muscle relaxer. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.

Methocarbamol is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Methocarbamol injection is sometimes used in the treatment of tetanus, (lockjaw) which causes painful tightening of the muscles.

Warnings

You should not use this medication if you are allergic to methocarbamol.

Before using methocarbamol, tell your doctor if you have myasthenia gravis.

You may need to reduce your dose after the first 2 or 3 days of treatment. Follow your doctor’s instructions regarding the number of tablets you take each day.

Methocarbamol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of this medicine.

Before taking this medicine

You should not use methocarbamol if you are allergic to it.

To make sure this medicine is safe for you, tell your doctor if you have:

• kidney disease;
• a seizure; or
• myasthenia gravis.

Methocarbamol may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Methocarbamol is not approved for use by anyone younger than 16 years old unless to treat tetanus.

How should I use methocarbamol?

Take methocarbamol exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Methocarbamol is only part of a complete treatment program that may also include rest, physical therapy, or other pain relief measures.

Methocarbamol oral is taken by mouth. You may need to reduce your dose after the first 2 or 3 days of treatment. Carefully follow your doctor’s dosing instructions.

Methocarbamol injection is injected into a muscle or given as an infusion into a vein. A healthcare provider will give you this injection.

The injection is usually given as a single dose before you start taking the oral form.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when methocarbamol is injected.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using this medicine.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Dosing information

Usual Adult Dose for Muscle Spasm:

ORAL:
Initial Dose: 1500 mg orally 4 times a day
-Doses of 6000 mg per day are generally used for the first 48 to 72 hours
-In severe cases, doses up to 8000 mg per day may be used

Maintenance dose:
500 mg tablets: 1000 mg orally 4 times a day
750 mg Tablets: 750 mg orally every 4 hours OR 1500 mg orally 3 times a day

PARENTERAL:
-For the relief of moderate symptoms: 1 g IV or IM once, then switch to oral
-For relief of severe symptoms or postoperative conditions: 1 g IV or IM every 8 hours
Maximum Dose: 3 g in 24-hours
Maximum Duration: 3 consecutive days; may repeat after a drug-free interval of 48 hours

Comments:
-Higher doses are recommended in the first 48 to 72 hours of treatment, then doses can usually be reduced to approximately 4000 mg per day.
-Oral tablets should be administered whenever feasible; IV/IM therapy should not be administered for more than 3 consecutive days without a drug-free interval of 48 hours.

Use: As an adjunct to rest and physical therapy for the relief of discomfort associated with acute, painful musculoskeletal conditions.

Usual Adult Dose for Tetanus:

Initial dose: 1 to 2 g IV followed by an additional 1 to 2 g via IV infusion
Maximal Initial Dose: 3 g

Repeat initial IV dose every 6 hours until NG tube or oral therapy is possible


Once NG tube is in place, may crush tablets, suspend in water or saline and administer through tube
-Total oral doses of up to 24 g may be needed based on patient response

Comments:
-There is clinical evidence to suggest this drug may have a beneficial effect in the control of the neuromuscular manifestations of tetanus.
-This drug should not replace the usual procedure of debridement, tetanus antitoxin, penicillin, tracheotomy, attention to fluid balance, and supportive care; if used, this drug should be added to the regimen as soon as possible.

Use: To control the neuromuscular manifestations of tetanus.

Usual Pediatric Dose for Tetanus:

Initial dose: 15 mg/kg or 500 mg/m2 IV; repeat initial dose every 6 hours as needed
Maximum dose: 1.8 g/m2/day IV for 3 consecutive days

Maintenance dose: May be given by injection into tubing or by IV infusion with an appropriate quantity of fluid

Comments:
-There is clinical evidence to suggest this drug may have a beneficial effect in the control of the neuromuscular manifestations of tetanus.
-This drug should not replace the usual procedure of debridement, tetanus antitoxin, penicillin, tracheotomy, attention to fluid balance, and supportive care; if used, this drug should be added to the regimen as soon as possible.

Use: To control the neuromuscular manifestations of tetanus.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line.

Overdose symptoms may include nausea, extreme drowsiness, fainting, seizure, or coma.

What to avoid

Avoid driving or hazardous activity until you know how methocarbamol will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Drinking alcohol with this medicine can cause side effects.

Methocarbamol side effects

Get emergency medical help if you have signs of an allergic reaction to methocarbamol: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using methocarbamol and call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• slow heartbeats;
• a seizure;
• jaundice (yellowing of your skin or eyes); or
• pain, bruising, swelling, or skin changes where the injection was given.

Common methocarbamol side effects may include:

• headache, dizziness, drowsiness;
• fever;
• confusion, problems with memory;
• nausea, vomiting, upset stomach;
• blurred vision, double vision;
• flushing (warmth, redness, or tingly feeling);
• sleep problems (insomnia); or
• lack of coordination.

What is Norflex?

Norflex is a muscle relaxer.

Norflex is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Norflex may also be used for purposes not listed in this medication guide.

Norflex side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Norflex may cause serious side effects. Stop using Norflex and call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• painful or difficult urination;
• little or no urination;
• confusion, anxiety, agitation, tremors, hallucinations; or
• pounding heartbeats or fluttering in your chest.

Common side effects of Norflex may include:

• dizziness, drowsiness, weakness;
• nausea, vomiting;
• dry mouth; or
• constipation.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA .

Warnings

You should not take Norflex if you have urination problems, an enlarged prostate, glaucoma, a stomach ulcer or blockage in your digestive tract, trouble swallowing, or myasthenia gravis.

Before taking this medicine

You should not use Norflex if you are allergic to it, or if you have:

• urination problems;
• an enlarged prostate;
• glaucoma;
• a stomach ulcer;
• a blockage in your stomach or intestines;
• trouble swallowing; or
• myasthenia gravis.

To make sure Norflex is safe for you, tell your doctor if you have:

• heart disease;
• a heart rhythm disorder;
• coronary artery disease; or
• if you also use a narcotic (opioid) medication.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether orphenadrine passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Norflex is not approved for use by anyone younger than 18 years old.

How should I take Norflex?

Follow all directions on your prescription label. Do not take Norflex in larger or smaller amounts or for longer than recommended.

Norflex may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Norflex is usually taken 2 times per day, once in the morning and once in the evening. Follow your doctor’s dosing instructions.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Norflex is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures.

Store Norflex at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Keep track of the amount of medicine used from each new bottle. Norflex is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking Norflex?

Norflex may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Do not drink alcohol. Dangerous side effects or death can occur.

What other drugs will affect Norflex?

Taking Norflex with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with orphenadrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

What is orphenadrine?

Orphenadrine is a muscle relaxer.

Orphenadrine is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Orphenadrine may also be used for purposes not listed in this medication guide.

Orphenadrine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Orphenadrine may cause serious side effects. Stop using orphenadrine and call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• painful or difficult urination;
• little or no urination;
• confusion, anxiety, agitation, tremors, hallucinations; or
• pounding heartbeats or fluttering in your chest.

Common side effects of orphenadrine may include:

• dizziness, drowsiness, weakness;
• nausea, vomiting;
• dry mouth; or
• constipation.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Warnings

You should not take orphenadrine if you have urination problems, an enlarged prostate, glaucoma, a stomach ulcer or blockage in your digestive tract, trouble swallowing, or myasthenia gravis.

Before taking this medicine

You should not use orphenadrine if you are allergic to it, or if you have:

• urination problems;
• an enlarged prostate;
• glaucoma;
• a stomach ulcer;
• a blockage in your stomach or intestines;
• trouble swallowing; or
• myasthenia gravis.

To make sure orphenadrine is safe for you, tell your doctor if you have:

• heart disease;
• a heart rhythm disorder;
• coronary artery disease; or
• if you also use a narcotic (opioid) medication.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether orphenadrine passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Orphenadrine is not approved for use by anyone younger than 18 years old.

How should I take orphenadrine?

Follow all directions on your prescription label. Do not take orphenadrine in larger or smaller amounts or for longer than recommended.

Orphenadrine may be habit-forming. Never share orphenadrine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Orphenadrine is usually taken 2 times per day, once in the morning and once in the evening. Follow your doctor’s dosing instructions.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Orphenadrine is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures.

Store orphenadrine at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Keep track of the amount of medicine used from each new bottle. Orphenadrine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Orphenadrine dosing information

Usual Adult Dose for Muscle Spasm:

Extended-Release Tablets: 100 mg orally twice a day

Parenteral Injection: 60 mg IV or IM every 12 hours as needed

Use: As an adjunct to rest, physical therapy and other measures for the relief of discomfort associated with acute painful musculoskeletal conditions.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking orphenadrine?

orphenadrine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Do not drink alcohol. Dangerous side effects or death can occur.

What other drugs will affect orphenadrine?

Taking orphenadrine with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with orphenadrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

What is Robaxin?

Robaxin is a muscle relaxer. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.

Robaxin is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Robaxin injection is sometimes used in the treatment of tetanus, (lockjaw) which causes painful tightening of the muscles.

Warnings

You should not use Robaxin if you are allergic to methocarbamol.

Before using Robaxin, tell your doctor if you have myasthenia gravis.

You may need to reduce your dose after the first 2 or 3 days of treatment.

Robaxin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of this medicine.

Before taking this medicine

You should not use Robaxin if you are allergic to methocarbamol.

To make sure this medicine is safe for you, tell your doctor if you have:

• kidney disease;
• a seizure; or
• myasthenia gravis.

Methocarbamol may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Robaxin is not approved for use by anyone younger than 16 years old unless to treat tetanus.

How should I use Robaxin?

Take Robaxin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. This medicine is only part of a complete treatment program that may also include rest, physical therapy, or other pain relief measures.

Robaxin oral is taken by mouth. You may need to reduce your dose after the first 2 or 3 days of treatment. Carefully follow your doctor’s dosing instructions.

Robaxin injection is injected into a muscle or given as an infusion into a vein. A healthcare provider will give you this injection.

The injection is usually given as a single dose before you start taking the oral form.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when the medicine is injected.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Robaxin.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Dosing information

Usual Adult Dose for Muscle Spasm:

PARENTERAL:
-For the relief of moderate symptoms: 1 g IV or IM once, then switch to oral
-For relief of severe symptoms or postoperative conditions: 1 g IV or IM every 8 hours
Maximum Dose: 3 g in 24-hours
Maximum Duration: 3 consecutive days; may repeat after a drug-free interval of 48 hours

Comments:
-Higher doses are recommended in the first 48 to 72 hours of treatment, then doses can usually be reduced to approximately 4000 mg per day.
IV/IM therapy should not be administered for more than 3 consecutive days without a drug-free interval of 48 hours.

Use: As an adjunct to rest and physical therapy for the relief of discomfort associated with acute, painful musculoskeletal conditions.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include nausea, extreme drowsiness, fainting, seizure, or coma.

What to avoid

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Drinking alcohol with this medicine can cause side effects.

Robaxin side effects

Get emergency medical help if you have signs of an allergic reaction to Robaxin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Robaxin and call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• slow heartbeats;
• a seizure;
• jaundice (yellowing of your skin or eyes); or
• pain, bruising, swelling, or skin changes where the injection was given.

Common Robaxin side effects may include:

• headache, dizziness, drowsiness;
• fever;
• confusion, problems with memory;
• nausea, vomiting, upset stomach;
• blurred vision, double vision;
• flushing (warmth, redness, or tingly feeling);
• sleep problems (insomnia); or
• lack of coordination.