Table 1.
Properties of commercially available botulinum toxin drugs
| Botox® | Dysport® | Xeomin® | NeuroBloc® Myobloc® | |
| Manufacturer | Allergan Inc. Irvine, CA, United States | Ipsen Pharma Boulogne-Billancourt, France | Merz Pharmaceuticals Frankfurt/M, Germany | United States WorldMeds Louisville, KY, United States |
| Pharmaceutical preparation | Powder | Powder | Powder | Ready-to-use solution 5000 MU-E/mL |
| Storage conditions | Below 8 °C | Below 8 °C | Below 25 °C | Below 8 °C |
| Shelf life | 36 mo | 24 mo | 36 mo | 24 mo |
| Botulinum toxin type | A | A | A | B |
| Clostridium botulinum strain | Hall A | Ipsen strain | Hall A | Bean B |
| SNARE target | SNAP25 | SNAP25 | SNAP25 | VAMP |
| Purification process | Precipitation and chromatography | Precipitation and chromatography | Precipitation and chromatography | Precipitation and chromatography |
| pH-value of the reconstituted preparation | 7.4 | 7.4 | 7.4 | 5.6 |
| Stabilisation | Vacuum drying | Freeze-drying (lyophilisate) | Vacuum drying | pH-reduction |
| Excipients | Human serum albumin 500 μg/100 MU-vial; NaCl 900 μg/100 MU-vial buffer system | Human serum albumin 125 μg/500 MU-vial; Lactose 2500 μg/100 MU-vial buffer system | Human serum albumin 1000 μg/100 MU-vial; Sucrose 4.7 mg/100 MU-vial buffer system | Human serum albumin 500 μg/mL; Disodium succinate 0.01 mol/L; Sodium chloride 0.1 mol/L; H2O; Hydrochloric acid |
| Biological activity | 50/100 MU-A/vial | 500 MU-I/vial | 50/100 MU-M/vial | 1.0/2.5/10.0 kMU-E/vial |
| Biological activity in relation to Botox® | 1 | 1:2-1:3 | 1 | 1:40 |
| Specific biological activity | 60 MU-EV/ngBNT | 100 MU-EV/ngBNT | 167 MU-EV/ngBNT | 5 MU-EV/ngBNT |
SNARE: Soluble NSF-attachment protein receptor; NSF: N-ethylmaleimide-sensitive fusion protein; SNAP-25: Synaptosomal-associated protein of 25 kD; BNT: Botulinum neurotoxin; MU-A: Mouse unit in the Allergan mouse lethality assay; MU-E: Mouse unit in the Solstice mouse lethality assay; MU-I: Mouse unit in the Ipsen mouse lethality assay; MU-M: Mouse unit in the Merz mouse lethality assay; MU-EV: Equivalence mouse unit. 1 MU-EV = 1 MU-A = 1 MU-M = 3 MU-I = 40 MU-E. Adapted with permission from Dressler[11].