TABLE 1.

Comparison of botulinum toxin preparations5

	ONABOTULINUMTOXINA	ABOBOTULINUMTOXINA	CBTX-A	BONTA
COMMERCIAL NAMES	Botox®, Botox Cosmetic®, Vistabel®, Vistabex®	Dysport®, Reloxin®, Azzalure®	Prosigne®, Lantox®	Neuronox®
COMPANY	Allergan Inc.	Medicis Pharmaceutical Corp.	Lanzhou Institute of Biological Products, China	Medy-Tox Inc., South Korea
TYPE	A	A	A	A
COUNTRIES	Worldwide, including United States and Canada	> 65 countries, including United States and Canada	> 10 countries including China, not in the United States or Canada	South Korea, India, South America, not in the United States or Canada
ACTIVE SUBSTANCE (MOLECULAR WEIGHT)	BTX-A complex (900 kD)	BTX-A complex (500–900 kD)	BTX-A (900 kD)	BTX-A (940 kD)
STRENGTH (BTX-A: PRODUCT)	1:1	1:2–1:4
INDICATIONS	Blepharospasm, cervical dystonia, glabellar lines, hyperhidrosis, chronic migraine, urinary incontinence, etc.	Blepharospasm, cervical dystonia, glabellar lines	Blepharospasm, cervical dystonia, glabellar lines, hyperhidrosis	Blepharospam
FDA APPROVAL	Botox®: cervical dystonia, severe primary axillary hyperhidrosis, blepharo- spasm, neurogenic detrusor overactivity (urinary incontinence), chronic migraine, upper limb spasticity Botox Cosmetic®: glabellar lines (moderate to severe)	Cervical dystonia, glabellar lines (moderate to severe)	None	None
MODE OF ACTION	SNAP-25	SNAP-25	SNAP-25	SNAP-25
PHARMACEUTICAL FORM	Powder	Powder	Powder	Powder
UNITS/VIAL	100 or 200	300 or 500	50 or 100	100
VOLUME	1.25 or 2.5mL, 10mL max	2.5mL to 5mL max
RECONSTITUTION	0.9% NaCl	0.9% NaCl
EXCIPIENTS	Human serum albumin, NaCl	Human serum albumin, lac- tose	Gelatin, dextran, sucrose	Human serum albumin, NaCl
STORAGE BEFORE DILUTION	2–8°C or < -5°C	2–8°C	2–8°C	2–8°C
STORAGE AFTER DILUTION	24 hours/2–8°C	4 hours/2–8°C	4 hours/2–8°C	4 hours/2–8°C

	INCOBOTULINUMTOXINA	TBD	RIMABOTULINUMTOXINB
COMMERCIAL NAMES	Xeomin®	PurTox®	MyoBloc®, NeuroBloc®
COMPANY	Merz Pharmaceuticals	Mentor Worldwide LLC	Solstice Neurosciences Inc.
TYPE	A	A	B
COUNTRIES	United States since 2011, Germany, other European countries, Mexico, Argentina, Brazil	Pending in the United States (Phase 3 trials completed)	United States, some European countries
ACTIVE SUBSTANCE (MOLECULAR WEIGHT)	BTX-A complex (150 kD); NO complexing proteins	BTX-A complex (150 kD); NO complexing proteins	BTX-B complex (700 kD)
STRENGTH (BTX-A:PRODUCT)	1:1	1:1.5	1:50–1:100
INDICATIONS	Blepharospasm, cervical dystonia, cosmetic use in some countries including glabellar lines in the United States	TBD; currently in Phase 3 trials	Cervical dystonia
FDA APPROVAL	Cervical dystonia, blepharospasm	Pending	Cervical dystonia
MODE OF ACTION	SNAP-25	SNAP-25	SNAP-25
PHARMACEUTICAL FORM	Powder	Powder
UNITS/VIAL	50 or 100		2,500; 5,000; 10,000
VOLUME	8mL		0.5mL; 1mL; 2mL
RECONSTITUTION	0.9% NaCl	0.9% NaCl	Not necessary
EXCIPIENTS	Human serum albumin, sucrose		Human serum albumin, NaCl, disodium succinate, water
STORAGE BEFORE DILUTION	2–8°C	< 25°C
STORAGE AFTER DILUTION	24 hours/2–8°C		4 hours (if diluted)/2–8°C