Reconstitution of Botulinum Toxin Type A Products

General Guidelines

• The Centers for Disease Control and Prevention (CDC) guidelines address botulinum antitoxin for treating botulism poisoning, which is fundamentally different from cosmetic/therapeutic botulinum toxin products like Xeomin 1, 2, 3
• Botulinum antitoxin neutralizes circulating toxin in poisoning cases, while Xeomin is a purified neurotoxin used therapeutically 5

Reconstitution Protocol

• For 50 units of Xeomin, add 1.25 mL of preservative-free 0.9% sodium chloride to achieve a concentration of 4 units per 0.1 mL 1
• For 100 units of Xeomin, add 2.5 mL of preservative-free 0.9% sodium chloride to achieve a concentration of 4 units per 0.1 mL 1
• Alternative dilution: add 2.0 mL to 100 units for a concentration of 5 units per 0.1 mL 1

Key Reconstitution Principles

• Use preservative-free 0.9% sodium chloride for injection only 1
• Inject diluent slowly and gently into the vial to avoid foaming 1
• Rotate vial gently; do not shake vigorously 1
• Use reconstituted solution within 24 hours when stored at 2-8°C 5