Overview
11 DESCRIPTION PrabotulinumtoxinA-xvfs is an acetylcholine release inhibitor and a neuromuscular blocking agent. PrabotulinumtoxinA-xvfs is supplied as a sterile, vacuum-dried powder in a single-dose vial intended for intramuscular use after reconstitution. PrabotulinumtoxinA-xvfs is a 900 kDa botulinum toxin type A, produced from fermentation of Clostridium botulinum .
Mechanism of Action
12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action JEUVEAU blocks neuromuscular transmission by binding to acceptor sites on motor nerve terminals, entering the nerve terminals, and inhibiting the release of acetylcholine. This inhibition occurs as the neurotoxin cleaves SNAP-25, a protein integral to the successful docking and release of acetylcholine from vesicles situated within nerve endings. When injected intramuscularly at therapeutic doses, JEUVEAU produces partial chemical denervation of the muscle resulting in a localized reduction in muscle activity. In addition, the muscle may atrophy, axonal sprouting may occur, and extrajunctional acetylcholine receptors may develop.
Indications
- 1 INDICATIONS AND USAGE JEUVEAU is indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients. JEUVEAU is an acetylcholine release inhibitor and a neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients ( 1 )
Common Doses
- 0.1 mL
- 0.5 mL
- 2.5 mL
Dosage
2 DOSAGE AND ADMINISTRATION Glabellar Lines Administration: 0.1 mL (4 Units) by intramuscular injection into each of five sites, for a total dose of 20 Units ( 2.2 , 2.3 ) 2.1 Instructions for Safe Use The potency Units of JEUVEAU (prabotulinumtoxinA-xvfs) for injection are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of JEUVEAU cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method [...
Black Box Warning
WARNING: DISTANT SPREAD OF TOXIN EFFECT The effects of all botulinum toxin products, including JEUVEAU, 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. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines. [ See Warnings and Precautions ( 5.
Contraindications
- 4 CONTRAINDICATIONS • Hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation ( 4.1 ) • Infection at the injection site ( 4.2 ) 4.1 Known Hypersensitivity to Botulinum Toxin JEUVEAU is contraindicated in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation [ See Warnings and Precautions ( 5.4 ) ]. 4.2 Infection at the Injection Site(s) JEUVEAU is contraindicated in the presence of infection at the proposed injection site(s).
Side Effects
- 6 ADVERSE REACTIONS The following serious adverse reactions are discussed in greater detail in other sections of the labeling: • Spread of Toxin Effects [ see Warnings and Precautions ( 5.1 ) ] • Hypersensitivity [ see Contraindications ( 4.1 ) and Warnings and Precautions ( 5.4 ) ] • Dysphagia and Breathing Difficulties [ See Warnings and Precautions ( 5.7 ) ] The most common adverse reactions are headache (12%), eyelid ptosis (2%), upper respiratory tract infection (3%), and increased white blood cell count (1%) ( 6.
Interactions
- 7 DRUG INTERACTIONS No formal drug interaction studies have been conducted with JEUVEAU (prabotulinumtoxinA-xvfs) for injection. However, the potential for certain drugs to potentiate the effects of JEUVEAU warrant consideration given the potential risks involved and should be used with caution. • Aminoglycosides or other agents interfering with neuromuscular transmission • Anticholinergic drugs • Botulinum neurotoxin products • Muscle relaxant Closely observe patients receiving concomitant treatment of JEUVEAU and aminoglycosides or other agents interfering with neuromuscular transmission (e.