What is Neurobloc?
NEUROBLOC® injection works by reducing or stopping muscle contractions. It contains the active ingredient ‘Botulinum Toxin Type B’. NEUROBLOC® is used to treat an illness called cervical dystonia (torticollis). This is where you have contractions of your neck or shoulder muscles that you cannot control. To allow division of the total dose between several injections, NEUROBLOC® may be diluted with sodium chloride 9mg/ml (0.9%) solution for injection. Once diluted, the medical product must be used immediately as the formulation does not contain a preservative.It should only be used by a doctor with specialist experience in the treatment of cervical dystonia and in the use of botulinum toxins.
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Important Information To Consider When Buying NeuroBloc® (Myobloc®)
Product Summary
NeuroBloc is a type of botulinum toxin medication that is used to treat cervical dystonia, or torticollis. This neurotoxin, which consists of the protein botulinum toxin type B, is able to treat the aforementioned neuromuscular disorder by causing a local paralysis of the affected muscles. This temporarily alleviates the involuntary muscular contractions that cause the disorder. This medication is a safe and effective form of treatment and is able to improve symptoms even in patients clinically resistant to other botulinum toxin treatments.
What makes a good candidate?
NeuroBloc is used in adults afflicted with torticollis to manage the associated symptoms of neck pain and abnormal head position. Because the botulinum toxin contained in this product is of a different type (type B) to other botulinum toxin injectables (type A), it is often proposed as an alternative treatment for patients that have become resistant to botulinum toxin type A.
This botulinum toxin treatment should not be used in patients with a known allergy to any of the components in the formulation. As well, this product should not be administered to patients with an active infection at the proposed site. There is no clinical data regarding the safety of using this botulinum toxin treatment for nursing or pregnant woman.
Areas treated with NeuroBloc
NeuroBloc is specifically indicated for the treatment of abnormal head position and neck pain associated with cervical dystonia. It is injected into the affected muscles that are involved in the dystonia. Muscles that can be treated include the sternocleidomastoid (SCM), semispinalis capitis, scalenus complex, trapezius, splenius capitis, levator scapulae, and longissimus capitis.
How does NeuroBloc work?
Cervical dystonia, or spasmodic torticollis is a rare neuromuscular disorder where uncontrolled contractions of the muscles in the neck cause involuntary turning, pulling, or tilting of the head or cause the head to sustain a prolonged position involuntarily. It is a painful condition with 75% of sufferers reporting neck pain and 30–40% experiencing a tremor of the head, which can often be debilitating.
Botulinum toxin injections to the affected muscles is a common and effective treatment for cervical dystonia. When injected into the affected muscle, NeuroBloc acts on nerve endings to inhibit the release of the neurotransmitter acetylcholine at the neuromuscular junction, effectively blocking neuromuscular conduct. This causes a localized paralysis that alleviates the involuntary muscular contractions that cause cervical dystonia.
Treatment details
This medication should only be administered by a licensed medical practitioner with knowledge in the treatment of cervical dystonia and the use of botulinum toxins. Prior to injection, ensure that the patient is fully informed of the expected outcome, indications, contraindications, precautions, and potential adverse events related to this treatment. Also ensure that a complete medical history of the patient is reviewed, especially information pertaining to previous treatments with botulinum toxin products.
This treatment is administered via intramuscular injection. Prepare the sites of injection by sterilizing the area to be treated with an appropriate antiseptic. If necessary, a local anesthetic may be administered in order to reduce the pain of injection. Administer an initial dose of 10,000 U, split between the 2 to 4 most affected muscles. Once diluted, this product must be used immediately.
How long does NeuroBloc last?
The effects of NeuroBloc are temporary; hence, repeat injections are required for the preservation of results. These should be repeated as necessary to maintain good function and minimize pain. Studies have shown that the average frequency of injections was approximately every 12 weeks; however, this varies according to individual. Results of this treatment may last up to 16 weeks. Dosing frequency should be adjusted according to the response of each individual patient.
Safety information
NeuroBlocs safety and efficacy for the treatment of cervical dystonia has been demonstrated in multiple clinical trials showing that treatment is effective, and results are long lasting, even in patients that have become clinically resistant to Type A botulinum toxin treatments.
The NeuroBloc unit measurement cannot be compared to or converted into units of any other botulinum toxin products.
The most commonly reported reactions associated with this treatment were dry mouth, dysphagia (difficulty swallowing), dyspepsia (indigestion), and injection site pain.
If injected incorrectly, botulinum toxin products may spread from the area of injection to produce adverse reactions such as exaggerated muscle weakness, dysphagia, dyspnea, aspiration pneumonia with fatal outcome in some cases. These events are serious and require immediate medical attention.
Recovery time
In many patients, NeuroBloc treatment will result in an improvement in symptoms within 5 days post-injection. As this is a minimally invasive procedure, no downtime is necessary for recovery and patients will be able to immediately resume their daily activities after the procedure.
Cost of NeuroBloc
The price of a NeuroBloc injection for the treatment of cervical dystonia varies according to the complexity of treatment, geographic location, and physician. You can determine the cost of this treatment in your clinic based on these factors.
