RimabotulinumtoxinB Injection


RimabotulinumtoxinB injection is used to relieve the symptoms of cervical dystonia (spasmodic torticollis; uncontrollable tightening of the neck muscles that may cause neck pain and abnormal head positions). RimabotulinumtoxinB injection is also used to treat chronic sialorrhea (ongoing drooling or excessive salivation). RimabotulinumtoxinB injection is in a class of medications called neurotoxins. When rimabotulinumtoxinB injection is injected into a muscle, it works by blocking the nerve signals that cause uncontrollable tightening and movement of the muscles. When rimabotulinumtoxinB is injected into saliva glands, it works by blocking the nerve signals that cause excessive saliva production.

Side Effects Of RimabotulinumtoxinB Injection

RimabotulinumtoxinB injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • redness, itching, pain, or swelling at the site of injection
  • headache
  • back pain

Some side effects of rimabotulinumtoxinB injection can be serious. If you experience any of these symptoms or those listed in the WARNING section, call your doctor immediately or get emergency medical help:

  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • hoarseness
  • shortness of breath
  • difficulty swallowing or breathing
  • chest pain
  • sudden weight gain
  • hives
  • hot flashes
  • dizziness or fainting
  • rash, especially on the cheeks or arms that worsens in the sun
  • unusual bruising or bleeding
  • pale skin
  • blistering skin
  • extreme tiredness
  • numbness or tingling
  • problems with vision
  • weakness in the arms or legs
  • joint pain
  • loss of appetite
  • red scaly patches and/or pus-filled bumps on the skin
  • Adults who receive rimabotulinumtoxinB injection may be more likely to develop skin cancer, lymphoma, and other types of cancer than people who do not receive rimabotulinumtoxinB injection. Talk to your doctor about the risks of receiving this medication.

RimabotulinumtoxinB injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Warnings & Precautions

Before using RimabotulinumtoxinB injection:

  • tell your doctor and pharmacist if you are allergic to rimabotulinumtoxinB injection; any other medications, latex or rubber, or any of the ingredients in rimabotulinumtoxinB injection. Ask your pharmacist or check the medication guide for a list of the ingredients. If you will be using the prefilled syringe, tell your doctor if you or the person who will be injecting the medication is allergic to latex.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the WARNING section. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had a disease that affects your nervous system, such as multiple sclerosis (MS; a disease in which the nerves do not function properly causing weakness, numbness, loss of muscle coordination, and problems with vision, speech, and bladder control) Guillain-Barré syndrome (weakness, tingling, and possible paralysis due to sudden nerve damage) or optic neuritis (inflammation of the nerve that sends messages from the eye to the brain); numbness, burning, or tingling in any part of your body; seizures; heart failure; any type of cancer; or bleeding problems or diseases that affect your blood.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using rimabotulinumtoxinB injection, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are using rimabotulinumtoxinB injection.
  • do not have any vaccinations without talking to your doctor.

RimabotulinumtoxinB Injection Dosage

RimabotulinumtoxinB injection comes as a powder to be mixed with sterile water and injected subcutaneously (just under the skin) by a doctor or nurse in a medical office and as a pre-filled syringe that you can inject subcutaneously by yourself at home. When rimabotulinumtoxinB injection is used to treat Crohn’s disease, it is usually given every two weeks for the first three doses and then every four weeks for as long as treatment continues. When rimabotulinumtoxinB injection is used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or axial spondyloarthritis, it is usually given every 2 weeks for the first three doses and then every 2 or 4 weeks for as long as treatment continues. When rimabotulinumtoxinB injection is used to treat plaque psoriasis, it is usually given every 2 weeks. If you are injecting rimabotulinumtoxinB injection yourself, follow the directions on your prescription label carefully. Do not inject more or less rimabotulinumtoxinB than prescribed by your doctor.

If you will be injecting rimabotulinumtoxinB injection by yourself at home or having a friend or relative inject the medication for you, ask your doctor to show you or the person who will be injecting the medication how to inject it. You and the person who will be injecting the medication should also read the written instructions for use that come with the medication.

Before you open the package containing your medication, check to be sure that the package is not torn, that the tamper-evident seals on the top and bottom of the package are not missing or broken and that the expiration date printed on the package has not passed. After you open the package, look closely at the liquid in the syringe. The liquid should be clear or pale yellow and should not contain large, colored particles. Call your pharmacist, if there are any problems with the package or the syringe. Do not inject the medication.

You may inject rimabotulinumtoxinB injection anywhere on your stomach or thighs except your navel (belly button) and the area 2 inches around it. Do not inject the medication into skin that is tender, bruised, red, or hard, or that has scars or stretch marks. Do not inject the medication in the same spot more than once. Choose a new spot at least 1 inch away from a spot that you have used before each time you inject the medication. If your doctor has told you to inject two syringes of rimabotulinumtoxinB for each dose, choose a different spot for each injection.

Do not reuse rimabotulinumtoxinB pre-filled syringes and do not recap the syringes after use. Discard used syringes in a puncture-resistant container. Ask your pharmacist how to discard the container.

RimabotulinumtoxinB injection may help to control your symptoms, but it will not cure your condition. Do not stop using rimabotulinumtoxinB injection without talking to your doctor.


Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body’s response to rimabotulinumtoxinB injection.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are using rimabotulinumtoxinB injection.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.