Xeomin, illustration of injection vial form (not a photo of the actual pack)

Illustrative image.

Xeomin

Incobotulinumtoxina

Prescription required

$210.00

50 units · 1 injection · 3 months supply

BrandBranded medicine· By Merz Pharmaceuticals

$70.00 per month

Strength

How long a supply?

3 months$70.00 a month
6 months$70.00 a month
Supplied from Israel

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Annual cost

$840a year at this pack size

Prescription required

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50 units

100units

FDA boxed warningDistant spread of toxin effect

Postmarketing reports indicate that the effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including lower limb spasticity in children, and in approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and at lower doses.

The effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults, particularly in those patients who have underlying conditions that would predispose them to these symptoms.

Read this with the rest of the clinical information

About Xeomin

Overview

Xeomin (incobotulinumtoxinA) is a botulinum toxin type A medicine given by injection. It treats chronic drooling and upper limb muscle stiffness or spasms in patients aged 2 years and older, and abnormal neck muscle contractions and eyelid spasms in adults. It also improves the appearance of moderate to severe frown lines, horizontal forehead lines and crow’s feet in adults. It works by blocking the release of a nerve-signalling chemical, reducing muscle activity or saliva production in the treated area.

What it treats

- Chronic excessive drooling in patients aged 2 years and older. - Upper limb spasticity (muscle stiffness) in patients aged 2 years and older. - Cervical dystonia (involuntary neck muscle contractions) in adults. - Blepharospasm (involuntary eyelid spasms) in adults. - Improvement in the appearance of moderate to severe frown lines between the eyebrows, horizontal forehead lines and crow’s feet caused by facial muscle activity in adults.

Safety information

Side effects

Common side effects vary by the condition treated: • Chronic drooling: dry mouth, diarrhea, high blood pressure and tooth extraction were reported in adults; bronchitis, headache, nausea and vomiting were reported in children. • Upper limb spasticity: seizures, nose and throat inflammation, dry mouth and upper respiratory tract infections were reported in adults; nose and throat inflammation and bronchitis were reported in children. • Cervical dystonia: difficulty swallowing, neck pain, muscle weakness, injection-site pain, and muscle or bone pain. • Eyelid spasms: drooping eyelids, dry eyes, vision problems and dry mouth. • Upper facial lines: bruising at the injection site. Seek immediate medical attention if breathing, speaking or swallowing difficulties develop. The toxin’s effects can spread beyond the injection site. The risk of these difficulties is increased in people with pre-existing muscle disorders or when injections into neck muscles on both sides are needed. Contact a doctor promptly for seizures, suspected allergic reactions, or eye symptoms such as dry eyes, vision changes or an eyelid turning outward. Treatment for eyelid spasms can leave the eye’s surface exposed and may cause corneal ulcers; protective measures may be needed.

FDA boxed warning

Distant spread of toxin effect

Postmarketing reports indicate that the effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including lower limb spasticity in children, and in approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and at lower doses.

The effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults, particularly in those patients who have underlying conditions that would predispose them to these symptoms.

A boxed warning is the strongest warning the US Food and Drug Administration requires on a medicine label. Text is taken from the official label, with internal section references removed.

When to call your doctor

- Trouble breathing or swallowing, seek medical attention immediately. - Trouble speaking, slurred speech or a changed voice. - New weakness throughout the body or unusual loss of strength. - Double or blurred vision, or drooping eyelids. - Loss of bladder control. Seek immediate medical attention for any of these symptoms, which can develop hours to weeks after injection.

If symptoms are severe or getting worse quickly, seek emergency care rather than waiting.

Before taking this medicine

Do not receive Xeomin if you are allergic to any botulinum toxin product or any ingredient in Xeomin, or if you have an infection at a planned injection site. Injecting into an infected site could cause a severe local infection or an infection that spreads. Extra caution is needed if you have a pre-existing muscle disorder or need injections into neck muscles on both sides, as these increase the risk of breathing, speech or swallowing difficulties. Seek immediate medical attention if these difficulties occur. Xeomin may cause corneal exposure and ulceration; protective measures may be needed. If you are pregnant, discuss this with your prescriber, as animal studies suggest Xeomin may harm the unborn baby. Xeomin potency units cannot be compared with or converted into units of other botulinum toxin products.

Interactions

Tell your doctor if you take aminoglycoside antibiotics or other medicines that affect signals between nerves and muscles. These may increase the effect of Xeomin. Using them together requires caution and close monitoring.

Using Xeomin

Dosing

Dosing is set by your prescriber. Each health care professional may prescribe medication differently according to a patient's medical history and condition, so follow the directions on your prescription label and speak to your doctor or pharmacist before changing anything.

Storage

Store in the original carton below 25°C, protected from light, unless the pack states refrigeration. Do not freeze. Keep all medicines out of the sight and reach of children.

Clinical information on this page is summarised from the US FDA label XEOMIN (INCOBOTULINUMTOXINA) INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [MERZ NORTH AMERICA, INC.] (DailyMed, retrieved 19 September 2026).

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