RimabotulinumtoxinB Injection

Generic name: Pronounced as (rim a bott' you lye num bee)
Brand names
  • Myobloc®
Click on drug name to hear pronunciation

Medical Content Reviewed By HelloPharmacist Staff

Last Revised - 09/15/2020

RimabotulinumtoxinB injection may spread from the area of injection and cause symptoms of botulism, including severe or life-threatening difficulty breathing or swallowing. People who develop difficulty swallowing during their treatment with this medication may continue to have this difficulty for several months. They may need to be fed through a feeding tube to avoid getting food or drink into their lungs. Symptoms can occur within hours of an injection with rimabotulinumtoxinB or as late as several weeks after treatment. Symptoms may occur in people of any age being treated for any condition, but the risk is probably highest in children being treated for spasticity (muscle stiffness and tightness). Tell your doctor if you have or have ever had any swallowing problems or breathing problems, such as asthma or emphysema, or any condition that affects your muscles or nerves such as amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease; condition in which the nerves that control muscle movement slowly die, causing the muscles to shrink and weaken), motor neuropathy (condition in which the muscles weaken over time), myasthenia gravis (condition that causes certain muscles to weaken, especially after activity), or Lambert-Eaton syndrome (condition that causes muscle weakness that may improve with activity). If you experience any of the following symptoms, call your doctor immediately: loss of strength or muscle weakness all over the body; double or blurred vision; drooping eyelids; difficulty swallowing, breathing, or speaking; or inability to control urination.

Your doctor will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with rimabotulinumtoxinB injection and each time you receive treatment. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.

RimabotulinumtoxinB injection is used to relieve the symptoms of cervical dystonia (spasmodic torticollis; uncontrollable tightening of the neck muscles that may cause neck pain and abnormal head positions). RimabotulinumtoxinB injection is also used to treat chronic sialorrhea (ongoing drooling or excessive salivation). RimabotulinumtoxinB injection is in a class of medications called neurotoxins. When rimabotulinumtoxinB injection is injected into a muscle, it works by blocking the nerve signals that cause uncontrollable tightening and movement of the muscles. When rimabotulinumtoxinB is injected into saliva glands, it works by blocking the nerve signals that cause excessive saliva production.

RimabotulinumtoxinB injection comes as a liquid to be injected into affected muscles or saliva glands by a doctor. Your doctor will choose the best place to inject the medication in order to treat your condition. You may receive additional injections of rimabotulinumtoxinB every 3 to 4 months, depending on your condition and how long the effects of the treatment last.

Your doctor will probably start you on a low dose of rimabotulinumtoxinB injection and gradually change your dose according to your response to the medication.

One brand or type of botulinum toxin cannot be substituted for another.

RimabotulinumtoxinB injection is also sometimes used to treat other conditions in which abnormal muscle tightening causes pain, abnormal movements, or other symptoms. RimabotulinumtoxinB injection is also sometimes used to treat certain types of migraine, overactive bladder (a condition in which the bladder muscles contract uncontrollably and cause frequent urination, urgent need to urinate, and inability to control urination), and anal fissures (a split or tear in the tissue near the rectal area). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before receiving rimabotulinumtoxinB injection,

  • tell your doctor and pharmacist if you are allergic to rimabotulinumtoxinB, abobotulinumtoxinA (Dysport), incobotulinumtoxinA (Xeomin), onabotulinumtoxinA (Botox), prabotulinumtoxinA-xvfs (Jeuveau), any other medications, or any of the ingredients in rimabotulinumtoxinB injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.

  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antibiotics such as amikacin, clindamycin (Cleocin), colistimethate (Coly-Mycin), gentamicin, lincomycin (Lincocin), neomycin, polymyxin, streptomycin, and tobramycin; medications for allergies, colds, or sleep; and muscle relaxants. Also tell your doctor if you have received injections of any botulinum toxin product in the past 4 months. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with rimabotulinumtoxinB, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

  • tell your doctor if you have swelling or other signs of infection in the area where rimabotulinumtoxinB will be injected. Your doctor will not inject the medication into an infected area.

  • tell your doctor if you have had surgery on your face, or if you have or have ever had any side effect from any botulinum toxin product or bleeding problems.

  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving rimabotulinumtoxinB injection, call your doctor.

  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving rimabotulinumtoxinB injection.

  • you should know that rimabotulinumtoxinB injection may cause loss of strength or muscle weakness all over the body or impaired vision. If you have any of these symptoms, do not drive a car, operate machinery, or do other dangerous activities.

Unless your doctor tells you otherwise, continue your normal diet.

  • RimabotulinumtoxinB injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

    • pain or tenderness in the area where the medication was injected

    • back, neck, or joint pain

    • headache

    • nausea

    • heartburn

    • dry mouth

    • cough

  • Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

    • itching

    • rash

    • hives

    • swelling of the face, throat, tongue, lips, or eyes

    • shortness of breath

    • wheezing

    • dizziness

    • fainting

  • RimabotulinumtoxinB injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

  • If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose usually do not appear right after receiving the injection. If you received too much rimabotulinumtoxinB or if you swallowed the medication, tell your doctor right away and also tell your doctor if you experience any of the following symptoms during the next several weeks:

  • weakness

  • difficulty moving any part of your body

  • difficulty breathing

Keep all appointments with your doctor.

Ask your pharmacist any questions you have about rimabotulinumtoxinB injection.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

  • BoNT-B
  • Botulinum Toxin Type B
  • BTB

Drug Interaction
Naratriptan Naratriptan The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Naratriptan.
Zolmitriptan Zolmitriptan The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Zolmitriptan.
Vancomycin Injection Vancomycin Injection The risk or severity of adverse effects can be increased when Vancomycin is combined with Botulinum Toxin Type B.
Linezolid Linezolid The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Linezolid.
Trimipramine Trimipramine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Trimipramine.
Glycopyrrolate Glycopyrrolate The risk or severity of adverse effects can be increased when Glycopyrronium is combined with Botulinum Toxin Type B.
Apomorphine Injection Apomorphine Injection The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Apomorphine.
Darifenacin Darifenacin The risk or severity of adverse effects can be increased when Darifenacin is combined with Botulinum Toxin Type B.
Pregabalin Pregabalin The therapeutic efficacy of Botulinum Toxin Type B can be increased when used in combination with Pregabalin.
Rasagiline Rasagiline The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Rasagiline.
Dronabinol Dronabinol Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Botulinum Toxin Type B.
Vigabatrin Vigabatrin The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Vigabatrin.
IncobotulinumtoxinA Injection IncobotulinumtoxinA Injection The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Botulinum toxin type A.
Lurasidone Lurasidone The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Lurasidone.
Vilazodone Vilazodone The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Vilazodone.
Clobazam Clobazam The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Clobazam.
Pomalidomide Pomalidomide The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Pomalidomide.
Levomilnacipran Levomilnacipran The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Levomilnacipran.
Vortioxetine Vortioxetine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Vortioxetine.
Perampanel Perampanel Perampanel may increase the central nervous system depressant (CNS depressant) activities of Botulinum Toxin Type B.
Eslicarbazepine Eslicarbazepine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Eslicarbazepine.
Suvorexant Suvorexant Botulinum Toxin Type B may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.
Tasimelteon Tasimelteon The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Tasimelteon.
Flibanserin Flibanserin The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Flibanserin.
Brexpiprazole Brexpiprazole The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Brexpiprazole.
Ziprasidone Injection Ziprasidone Injection The risk or severity of adverse effects can be increased when Ziprasidone is combined with Botulinum Toxin Type B.
Cariprazine Cariprazine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Cariprazine.
Eluxadoline Eluxadoline The risk or severity of respiratory depression can be increased when Eluxadoline is combined with Botulinum Toxin Type B.
Brivaracetam Injection Brivaracetam Injection The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Brivaracetam.
Pimavanserin Pimavanserin The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Pimavanserin.
Safinamide Safinamide The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Safinamide.
Buprenorphine Injection Buprenorphine Injection Botulinum Toxin Type B may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.
Plazomicin Injection Plazomicin Injection The risk or severity of adverse effects can be increased when Plazomicin is combined with Botulinum Toxin Type B.
Cannabidiol Cannabidiol The risk or severity of adverse effects can be increased when Cannabidiol is combined with Botulinum Toxin Type B.
Stiripentol Stiripentol The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Stiripentol.
Brexanolone Injection Brexanolone Injection The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Brexanolone.
Solriamfetol Solriamfetol The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Solriamfetol.
Viloxazine Viloxazine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Viloxazine.
Tobramycin Injection Tobramycin Injection The risk or severity of adverse effects can be increased when Tobramycin is combined with Botulinum Toxin Type B.
Trazodone Trazodone The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Trazodone.
Bromocriptine Bromocriptine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Bromocriptine.
Tranylcypromine Tranylcypromine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Tranylcypromine.
Tetracycline Tetracycline The risk or severity of adverse effects can be increased when Tetracycline is combined with Botulinum Toxin Type B.
Thioridazine Thioridazine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Thioridazine.
Trifluoperazine Trifluoperazine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Trifluoperazine.
Benztropine Benztropine The risk or severity of adverse effects can be increased when Benzatropine is combined with Botulinum Toxin Type B.
Trihexyphenidyl Trihexyphenidyl The risk or severity of adverse effects can be increased when Trihexyphenidyl is combined with Botulinum Toxin Type B.
Carbamazepine Carbamazepine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Carbamazepine.
Gentamicin Injection Gentamicin Injection The risk or severity of adverse effects can be increased when Gentamicin is combined with Botulinum Toxin Type B.
Valproic Acid Valproic Acid The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Valproic acid.
Baclofen Baclofen The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Baclofen.
Brompheniramine Brompheniramine The risk or severity of adverse effects can be increased when Brompheniramine is combined with Botulinum Toxin Type B.
Carisoprodol Carisoprodol The risk or severity of adverse effects can be increased when Carisoprodol is combined with Botulinum Toxin Type B.
Butorphanol Injection Butorphanol Injection The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Butorphanol.
Acetazolamide Acetazolamide The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Acetazolamide.
Thiothixene Thiothixene The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Thiothixene.
Temazepam Temazepam The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Temazepam.
Triazolam Triazolam The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Triazolam.
Hyoscyamine Hyoscyamine The risk or severity of adverse effects can be increased when Hyoscyamine is combined with Botulinum Toxin Type B.
Tramadol Tramadol The risk or severity of CNS depression can be increased when Tramadol is combined with Botulinum Toxin Type B.
Mirtazapine Mirtazapine Botulinum Toxin Type B may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.
Donepezil Donepezil The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Donepezil.
Cetirizine Cetirizine The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Cetirizine.
Efavirenz Efavirenz The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Efavirenz.
Tolterodine Tolterodine The risk or severity of adverse effects can be increased when Tolterodine is combined with Botulinum Toxin Type B.
Thalidomide Thalidomide Botulinum Toxin Type B may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
Levetiracetam Levetiracetam The risk or severity of adverse effects can be increased when Botulinum Toxin Type B is combined with Levetiracetam.

Content provided by: AHFS® Patient Medication Information™. © Copyright, 2021. The American Society of Health-System Pharmacists