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Generic Name: incobotulinumtoxinA (IN koe BOT ue LYE num TOX in A)
Brand Names: Xeomin
Xeomin (incobotulinumtoxinA) is used to treat cervical dystonia, blepharospasm, glabellar lines, upper limb spasticity, and excessive drooling. Includes Xeomin side effects, interactions and indications.
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Drug Information:
Xeomin (incobotulinumtoxinA, also called botulinum toxin type A), is made from the bacteria that causes botulism. Botulinum toxin blocks nerve activity in the muscles, causing a temporary reduction in muscle activity. Xeomin injection is used to treat cervical dystonia (severe spasms in the neck muscles), or muscle stiffness in the elbows, wrists, fingers, ankles, or toes. Xeomin is also used to treat certain eye muscle conditions caused by nerve disorders. This includes uncontrolled blinking or spasm of the eyelids, and a condition in which the eyes do not point in the same direction. Learn more

Xeomin Side Effects

Xeomin Side Effects

Note: This document contains side effect information about incobotulinumtoxinA. Some of the dosage forms listed on this page may not apply to the brand name Xeomin.

In Summary

Common side effects of Xeomin include: asthenia, blepharoptosis, dysphagia, myasthenia, neck pain, visual disturbance, and xerostomia. Other side effects include: dyspnea, diarrhea, musculoskeletal pain, and pain at injection site. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to incobotulinumtoxinA: powder for solution


Intramuscular route (Powder for Solution)

The effects of incobotulinumtoxinA and all botulinum toxin products 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. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults, particularly in those patients who have underlying conditions that would predispose them to these symptoms. Cases of spread of effect have occurred at doses comparable to those used to treat cervical dystonia and at lower doses.

Along with its needed effects, incobotulinumtoxinA (the active ingredient contained in Xeomin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking incobotulinumtoxinA:

More common—for cervical dystonia

  • Difficulty with swallowing
  • muscle or bone pain
  • muscle weakness
  • pain in the neck

More common—for blepharospasm

  • Dry eyes

Less common—for sialorrhea

  • Blurred vision
  • cough producing mucus
  • difficulty breathing
  • dizziness
  • headache
  • nervousness
  • pounding in the ears
  • slow or fast heartbeat
  • tightness in the chest

Rare—for glabellar lines

  • Itching, pain, redness, or swelling at the injection site
  • pain in the face
  • swelling of the eyelids

Incidence not known

  • Changes in patterns and rhythms of speech
  • fast heartbeat
  • fever
  • hives, itching, or rash
  • hoarseness
  • irritation
  • joint pain, stiffness, or swelling
  • muscle spasm
  • pain at the injection site
  • redness of the skin
  • slurred speech
  • swelling of the eyes or eyelids
  • swelling of the face, lips, hands, or feet
  • tightness in the chest
  • trouble with speaking
  • troubled breathing or swallowing

Some side effects of incobotulinumtoxinA may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common—for cervical dystonia

  • Chills
  • cough
  • lower back or side pain
  • painful or difficult urination

More common—for blepharospasm

  • Blurred vision
  • diarrhea
  • drooping upper eyelids
  • dry mouth
  • headache

Less common—for blepharospasm

  • Difficult or labored breathing
  • muscle aches
  • sneezing
  • sore throat
  • stuffy or runny nose
  • unusual tiredness or weakness

Less common—for sialorrhea

  • Back pain
  • diarrhea
  • dry eye
  • dry mouth
  • falls
  • hoarseness
  • sore throat
  • voice changes

Less common—for upper limb spasticity

  • Dry mouth
  • fever
  • headache
  • muscle aches
  • sore throat
  • stuffy or runny nose
  • unusual tiredness or weakness

Rare—for glabellar lines

  • Drooping of the eyelids
  • increased blinking
  • twitching of the eyelids

Incidence not known

  • Difficulty with moving
  • joint pain
  • muscle ache, cramps, pain, or stiffness
  • nausea
  • painful blisters on the trunk of the body
  • swollen joints

For Healthcare Professionals

Applies to incobotulinumtoxinA: intramuscular powder for injection


The frequency of adverse reactions varies based on usage. The more frequently reported adverse events in the chronic sialorrhea trials included tooth extraction, dry mouth, diarrhea, and hypertension; in the upper limb spasticity trials, seizure, nasopharyngitis, dry mouth, and upper respiratory tract infection; in the cervical dystonia trials, dysphagia, neck pain, and muscle weakness; for blepharospasm, eyelid ptosis, dry eye, and dry mouth; and for treating glabellar lines, the most frequently reported adverse event was headache.


Common (1% to 10%): Injection site pain, injection site hematoma

Very rare (less than 0.01%): Spread of toxin

Frequency not reported: Injection site reaction, allergic dermatitis, localized allergic reactions (e.g., welling, edema, erythema, pruritus, rash), herpes zoster


Common (1% to 10%): Asthma, nasopharyngitis, respiratory tract infection, dyspnea, bronchitis


Hypersensitivity reactions including anaphylaxis, serum sickness, urticaria, soft tissue edema, and dyspnea have been reported with botulinum toxin products. Localized allergic reactions reported during the postmarketing period with this drug include swelling, edema, erythema, pruritus, or rash.

Postmarketing reports: Localized allergic reactions, hypersensitivity, allergic dermatitis


Common (1% to 10%): Dry eye (19%), eyelid ptosis (19%)

Uncommon (0.1% to 1%): Impaired vision, blurred vision, lacrimation increased, eye swelling, eyelid edema, diplopia


Very common (10% or more): Neck pain (up to 16%), muscular weakness (up to 14%)

Common (1% to 10%): Musculoskeletal pain, muscle spasms, musculoskeletal stiffness, back pain

Uncommon (0.1% to 1%): Pain in extremity, muscular weakness, dysarthria, myalgia

Nervous system

Common (1% to 10%): Headache, dizziness, epilepsy, dysphonia

Uncommon (0.1% to 1%): Speech disorder, dysesthesia


Very common (10% or more): Dysphagia (18%), dry mouth (16%)

Common (1% to 10%): Diarrhea, nausea, oropharyngeal pain, lip disorder, viral gastroenteritis, tooth extraction


Common (1% to 10%): Sinusitis, nasopharyngitis, respiratory tract infection, viral gastroenteritis, tooth infection

Postmarketing reports: Flu-like symptoms, herpes zoster


Common (1% to 10%): Urinary tract infection


Common (1% to 10%): Hypertension


Common (1% to 10%): Hypercholesterolemia, hyperglycemia


Common (1% to 10%): Asthenia

Uncommon (0.1% to 1%): Dysphonia, facial paresis, feeling hot

Rare (less than 0.1%): Tenderness


Postmarketing reports: Allergic dermatitis

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Xeomin