Contraindications
Botulinum toxin injections should not be used in pregnancy or when breast feeding. It is also inadvisable for those with certain neurological conditions such as motor neurone disease or myasthenia gravis.
Caution is necessary for patients on the following medications:
- Aminoglycoside antibiotics (may increase effect of botulinum toxin).
- Chloroquine and hydroxychloroquine (may reduce effect).
- Blood thining agents eg. warfarin or aspirin (may result in bruising).
Occasionally the injection fails to result in the desired muscle weakness. The treatment can be repeated, but to reduce the chance of the development of neutralising antibodies, it is recommended that the treatment is not given again for two months.
