Xeomin(®) (
incobotulinumtoxinA; Merz
Pharmaceuticals, Frankfurt am Main, Germany) was first introduced in Germany for
movement disorders in 2005. In 2010, it was approved for use in the United States by the FDA for the treatment of
cervical dystonia (CD) and
blepharospasm. It is a unique botulinum type A formulation free of any complexing
proteins and contains only the pure 150 kD
neurotoxin. Thus, the formation of
neutralizing antibodies is not induced even after long-term treatment. The purpose of this report is to review the safety profile and dosing schedule for
Xeomin for the treatment of CD and
blepharospasm. The recommended dose for patients with CD is 120 U/treatment, with administration intervals normally between 3 and 6 months. However, clinical studies have found
Xeomin to be safe and effective at doses up to 400 U in both previously treated and treatment-naïve patients. The recommended starting dose in patients with
blepharospasm is 2.5-5.0 U/injection site. Patients can be switched using a 1:1 conversion ratio from
Botox(®) (
onabotulinumtoxinA,
Allergen Inc., Irvine, CA, USA) to
Xeomin without any loss of efficacy or safety concerns.
Xeomin does not differ from
Botox in terms of its potency, onset, diffusion profile, or duration and waning of effect. It is the only botulinum treatment that is stable for up to 3 years at room temperature.
Xeomin offers a new and important treatment option for
movement disorders.