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CP-048 Analysis of the ambulatory use of botulinum toxin type a in a tertiary hospital: authorised and off-label indications
  1. MA Fernandez de Palencia Espinosa,
  2. V Arocas Casañ,
  3. MJ Sánchez Garre,
  4. L Menéndez Naranjo,
  5. MM Galindo Rueda,
  6. S Vicente Sánchez,
  7. A De la Rubia Nieto
  1. University Hospital Virgen de La Arrixaca, Pharmacy, Murcia, Spain


Background In Spain, the authorised indications for botulinum toxin type A (BTTA, Botox) are:

  • Neurological diseases: focal spasticity (foot, wrist and hand, ankle), blepharospasm, hemifacial spasm and associated focal dystonias, cervical dystonia and chronic migraine in adults.

  • Bladder disorders: urinary incontinence in adults with neurogenic detrusor overactivity or idiopathic overactive bladder.

  • Skin disorders: Severe primary axillary hyperhidrosis.

Purpose To analyse the ambulatory use of BTTA in our hospital for one year.

Material and methods A retrospective descriptive analysis of all patients treated with BTTA from May 2013 to April 2014 was carried out. Records from the hospital’s electronic prescribing software (Silicon software) were reviewed and the following data were collected: number of patients and prescriptions dispensed, indications and clinical department.

Results A total of 431 patients were treated with BTTA, counting 611 prescriptions dispensed. Two patients received 4 doses, 18 patients 3 doses, 138 patients 2 doses and 273 patients one dose.

The distribution of administrations by clinical department and indication was:

  • Pain Unit: focal spasticity (5), hemifacial spasm (1), off-label: different pains in back, neck and extremities (5)

  • Maxillofacial Surgery: hemifacial spasm and associated focal dystonias or disorders in the facial nerve (27)

  • Ophthalmology: blepharospasm (2) and off-label: strabismus or esotropia (33)

  • General surgery: off-label: anal fissure (8)

  • Plastic Surgery: hemifacial spasm and associated focal dystonias (12)

  • Dermatology: hyperhidrosis (41)

  • Neurophysiology: off-label: idiopathic peripheral neuropathy (1) and paralysis of vocal cords (3)

  • Neurology: blepharospasm (32), cervical dystonia (48), hemifacial spasm (23), focal spasticity (64), hyperhidrosis (10), migraine (7)

  • Otolaryngology: off-label: sialorrhea (10) and oropharynx malignant neoplasm (2)

  • Urology: urinary incontinence (57)

  • Rehabilitation: cervical dystonia (1), hemifacial spasm (1), focal spasticity (247), off-label: complication of amputation stump (1)

Conclusion In our hospital, BTTA is mainly used in authorised conditions. Neurology and Rehabilitation call on BTTA most frequently. General Surgery, Ophthalmology and Otolaryngology respond to off-label conditions in most of their patients.

References and/or Acknowledgements No conflict of interest.

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