Full Prescribing Information including Medication Guide | Patients

Using XEOMIN®

Consistency With Every Treatment

From mastering your technique to navigating patient conversations, feel supported at every step using XEOMIN.

Actual patient. Individual results may vary.

Reconstituting XEOMIN

Here’s what you need to know to get XEOMIN ready to use.

Always double-check whether you have the 50 or 100 unit vial before you start diluting—and remember to use sterile, preservative-free 0.9% sodium chloride injection, USP.

Vial of 100 units of XEOMIN.

Step 1: Prep Your Vial

Give the rubber stopper a quick swipe with an alcohol wipe (70%).1

Visualization of wiping a vial

Step 2: Add Saline

Gently push the needle straight through the stopper and ease the saline into the vial (aim for a smooth pour here—no bubbles or foam, please). If the vacuum doesn’t pull the saline in, play it safe and don’t use that vial.1

Needle pushing saline into a vial

Step 3: Gently Flip and Swirl

Remember to invert and swirl the vial. The powder should be fully dissolved and the solution should be perfectly clear and colorless if done properly. Let it sit 3-5 minutes before using. If it looks cloudy or has visible particles, it’s a no-go and discard the vial.1

Visualization of inverting and swirling vial
Gloved hands with a vial of Xeomin

Watch and Learn

Visit the Merz Aesthetics Exchange (MAX) Portal to watch a reconstitution demo and see these steps in action.

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Simple to Store. Ready to Use.

With no refrigeration required prior to reconstitution and simple storage requirements, XEOMIN is designed to support everyday practice operations.1

Unopened vials of XEOMIN should be stored at or below 25°C (77°F). Reconstituted XEOMIN solution should be administered within 24 hours after dilution. During this time period, reconstituted XEOMIN should be stored in a refrigerator at 2-8°C (36-46°F).1

Boxes of Xeomin on a shelf

Your Guide to Injecting XEOMIN

Check out these detailed instructions for reconstituting XEOMIN, assessing patient anatomy, and crafting a personalized treatment plan.

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Woman getting injected with XEOMIN.

Administering XEOMIN for Upper Facial Lines

With 64 units, XEOMIN is designed for smooth, natural results across glabellar, forehead, and lateral canthal lines—supporting a harmonized aesthetic.1

Maximum Recommended Dose: 20 units

You’ll use up to 20 units, split evenly into five 4-unit intramuscular injections. Think 2 injections in each corrugator muscle and 1 in the procerus muscle.

Woman scowling to show frown lines with a pink circle around them
See Before & After

Maximum Recommended Dose: 20 units

Distribute up to 20 units across the frontalis muscle, taking into account an individual assessment of the patient’s anatomy, expression, and muscle strength. Make sure you’re at least 2 cm above the orbital rim.

Woman raising her eyebrows to show forehead lines with a pink circle around them
See Before & After

Maximum Recommended Dose: 24 units (12 per side)

You’ll inject up to 4 units into 3 points on each side (that’s 6 total injection sites) in the lateral orbicularis oculi muscle, for 12 units per side (up to 24 units total):

  • Place one injection about 1 cm lateral from the bony orbital rim, in the horizontal extension of the lateral canthus
  • Place the other two injections roughly 1 cm above and below that first injection
Woman smiling to show crow's feet with a pink circle around them
See Before & After
Woman scowling to show frown lines with a pink circle around them
Woman raising her eyebrows to show forehead lines with a pink circle around them
Woman smiling to show crow's feet with a pink circle around them

Actual patient (pictured before XEOMIN treatment). Individual results may vary.

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Step-by-Step Injection Training

XEOMIN is backed by a full suite of virtual and in-person training tools—so integrating it into your practice is smooth and straightforward.

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Start Offering XEOMIN

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Bring on the Before-and-Afters!

Discover real stories and results from patients who have experienced the XEOMIN difference.

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WARNING: DISTANT SPREAD OF TOXIN EFFECT
See full prescribing information for complete BOXED WARNING.
The effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects.

INDICATIONS AND USAGE

XEOMIN® (incobotulinumtoxinA) for injection, for intramuscular use is indicated for the temporary improvement in the appearance of moderate to severe upper facial lines in adults (glabellar lines with corrugator and/or procerus muscle activity [GL], horizontal forehead lines associated with frontalis muscle activity [HFL], and lateral canthal lines associated with orbicularis oculi activity [LCL].)

IMPORTANT SAFETY INFORMATION

WARNING: DISTANT SPREAD OF TOXIN EFFECT

See full prescribing information for complete BOXED WARNING.

The effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults, particularly in those patients who have underlying conditions that would predispose them to these symptoms.

CONTRAINDICATIONS

Hypersensitivity reactions have been reported with botulinum toxin products (anaphylaxis, serum sickness, urticaria, soft tissue edema, and dyspnea). If serious and/or immediate hypersensitivity reactions occur further injection of XEOMIN should be discontinued and appropriate medical therapy immediately instituted. XEOMIN is contraindicated in patients with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.

Use in patients with an infection at the injection site could lead to severe local or disseminated infection. XEOMIN is contraindicated in the presence of infection at the proposed injection site(s).

WARNINGS AND PRECAUTIONS

  • Treatment with XEOMIN and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. When distant effects occur, additional respiratory muscles may be involved. Patients may require immediate medical attention should they develop problems with swallowing, speech, or respiratory disorders. Dysphagia may persist for several months, which may require use of a feeding tube. Aspiration may result from severe dysphagia [See BOXED WARNING].
  • The potency Units and Units of biological activity of XEOMIN are specific to their respective preparation and assay method utilized, and thus cannot be compared or converted into Units of any other botulinum toxin products.
  • Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junctional disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) should be monitored particularly closely when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including severe dysphagia and respiratory compromise from typical doses of XEOMIN.
  • Upper Facial Lines: Do not exceed the recommended dosage and frequency of administration of XEOMIN.
    • GL: To reduce the complication of ptosis avoid injection near the levator palpebrae superioris, particularly in patients with larger brow depressor complexes. Corrugator injections should be placed at least 1 cm above the bony supraorbital ridge.
    • HFL: Treat HFL in conjunction with GL to minimize the potential for brow ptosis.
    • LCL: Avoid injections too close to the zygomaticus major muscle to prevent lip ptosis.
  • Use caution when XEOMIN is used in patients who have marked facial asymmetry, with surgical alterations to the facial anatomy, pre-existing eyelid or eyebrow ptosis, when excessive weakness or atrophy is present in the target muscles, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin (e.g., the inability to substantially lessen glabellar lines even by physically spreading them apart).
  • Caution should be taken when XEOMIN is used where the targeted muscle shows excessive weakness or atrophy.
  • XEOMIN contains human serum albumin. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been reported for albumin.

ADVERSE REACTIONS

Upper Facial Lines (Glabellar Lines, Horizontal Forehead Lines, and Lateral Canthal Lines): The most commonly observed adverse reaction (incidence ≥ 1% of patients and greater than placebo) for XEOMIN was injection site bruising (2%).

DRUG INTERACTIONS

Co-administration of XEOMIN and aminoglycoside or other agents interfering with neuromuscular transmission, (e.g., muscle relaxants), should only be performed with caution as these agents may potentiate the effect of the toxin.

Use of anticholinergic drugs after administration of XEOMIN may potentiate systemic anticholinergic effects. The effect of administering different botulinum toxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.

USE IN PREGNANCY

There are no adequate data on the developmental risk associated with the use of XEOMIN in pregnant women. XEOMIN should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

PEDIATRIC USE

Safety and effectiveness of XEOMIN for upper facial lines in patients less than 18 years of age have not been established.

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Reference: 1. Xeomin [Prescribing Information]. Franksville, WI: Merz North America, Inc; 2023.