Xeomin® is an incobotulinumtoxinA product and is a competitor to the more recognized Botox Cosmetic® and also Dysport®.
The IAPAM queried its faculty for an overview of the differences between the 3 products.
All the experts we queried agreed that the key to using any of these products: Botox® vs Dysport® vs Xeomin® is to first engage in a comprehensive injectables training program that includes all three as part of the didactic.
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Since Botox®, in comparison to Dysport® and Xeomin®, is the more commonly used neurotoxin in aesthetic medicine.
Botox®, scientifically known as onabotulinumtoxin A, works by causing temporary paralysis of muscles in the area where it is injected. It is used mainly to manage fine lines and wrinkles, as well as treatment of migraines.
Dysport®, which is scientifically known as abobotulinumtoxin A, is similar to Botox®, except that currently it is used mainly in the treatment of cervical dystonia. Finally, Xeomin®- or scientifically known as icobotulinumtoxin A, has very similar uses and protocols as Botox®.
As mentioned above, both Dysport® and Botox® cause paralysis in the neuromuscular junction. They are both used for treating fine lines and wrinkles. However, their differences are more extensive.
Dysport® is usually used to manage cervical dystonia, or spasmodic torticollis, which is an abnormal tone in the muscles of the neck, resulting in an abnormal head position. Botox® is not usually used to treat this condition.
Further, Dysport® has the ability to take effects on the injection site a lot faster than Botox®. For example, it is estimated that the results of Dysport® are seen around 48 hours after injection while Botox® can take up to 7 days to show any results.
The duration of action between the two is also quite different. For example, it is estimated that Dysport® can last up to 4 months. How long does Botox® last? Typically, it only lasts around 3 months. This ultimately has an effect on how many injections will have to be administered to patients who need long-term treatment.
However, one needs to consider the dosages of the drugs, as larger doses of Dysport® need to be given – 3 units – compared to Botox®, which only needs one unit, to see results.
Finally, Dysport® is cheaper than Botox®, and the storage of the two products differs. Botox® is freeze-dried and needs to be stored either frozen at -5°C or refrigerated between 2 to 8°C until it three. Dysport® only needs to be stored between 2 to 8°C once it is re-formed for use. For more information from the IAPAM’s faculty of dermatologists, please read our expert discussion on Botox® vs Dysport®.
There are a number of similarities between Xeomin® and Botox®. These are listed below –
1. Both Xeomin® and Botox® consist of the same basic ingredient – Botulinum toxin A, a toxin that this produced by the Clostridium botulinum bacteria. This neurotoxin acts by blocking the neuromuscular junction and has an effect on the skin and muscles it is injected into.
2. Both Xeomin® and Botox® exert their effect in around 7 days after it has been injected, with the effects lasting up to 6 months. The overall effect that results from Xeomin® and Botox® are the same.
3. Both Xeomin® and Botox® are measured in the same units, making it easy for the treating physician to measure up the required dose.
4. The cost of Xeomin® and Botox® are comparable, making the administration of either drug a choice that can lie with the physician or the patient.
There are only a few differences between Xeomin® and Botox®. These have been listed below:
1. The basic structure of Xeomin® and Botox® are different, even though the toxin is the same. Botox® is encased within a protein structure, while Xeomin lacks this protein covering and is, in fact, the ‘naked’ botulinum toxin. This protein casing on Botox can cause immune reactions that can eventually block the actions on botulinum toxin when injected. It is believed that this is an advantage that Xeomin® bears over Botox as it results in no antibody formation with repeated injections of Xeomin®.
2. Botox® is stored in a freezer or at temperatures between 2 to 8°C. It, therefore, requires it to be transported in a freezer. On the other hand, Xeomin® does not necessarily need to be stored in a freezer or refrigerator, making transporting the product a lot easier and even cheaper.
3. Xeomin® is manufactured by Merz Pharma while Botox® is manufactured by Allergan.
In most cases, Xeomin® can be offered if patients develop antibodies to Botox®.
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Please note: Botox, Allergan Botox Cosmetic and Juvederm are registered trademarks of Allergan, Inc. Dysport, Restylane and Perlane are registered trademarks of Galderma. Xeomin is a registered trademark of Merz Pharmaceuticals, LLC.
DISCLOSURE OF UNLABELED USE
This document contains a discussion of agents that are not indicated by the U.S. Food and Drug Administration. The International Association for Physicians in Aesthetic Medicine (IAPAM), Allergan, Inc., and Medicis, Inc., do not recommend the use of any agent outside of the labeled indications. The opinions expressed in this document are those of the contributors and do not necessarily represent the views of the IAPAM, Allergan, Inc. or Medicis, Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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