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The only approved botulinum toxin for chronic sialorrhea that can provide significant results in just one week1,2
*Actor portrayal
Help restore confidence and comfort to your patients and their caregivers with quick and effective symptom relief


Blocks acetylcholine (Ach) release at the cholinergic neurosecretory junction of the salivary glands1
MYOBLOC cleaves synaptic vesicle-associated membrane protein (VAMP)*
  • This blocking action reduces saliva production
  • MYOBLOC has a sensitivity to cholinergic autonomic neurons, especially post-ganglionic neurons containing M3 receptors3,4

*VAMP is a component of the protein complex responsible for docking and fusion of the synaptic vesicle to the presynaptic membrane, a necessary step to neurotransmitter release.

Quick and effective relief of chronic sialorrhea


Clinical Development Program1,5

Phase 3, double-blind, placebo-controlled, single-treatment efficacy and safety study

  • 187 patients enrolled
  • 3 dose arms: 2,500 Units (n=63) or 3,500 Units (n=64) versus matching placebo (n=60)
  • Objectives: Determine efficacy, safety, and tolerability over a 13-week period
  • Primary efficacy measures: Unstimulated Salivary Flow Rate (USFR) and Clinical Global Impression of Change (CGI-C) at Week 4

Both doses statistically significant at Week 4 for USFR and CGI-C1

MYOBLOC treatment resulted in a significantly greater reduction in USFR vs. placebo1

  • Reductions began at Week 1 and continued through Week 8 for both doses tested
  • Significant effect continued through to Week 13 for the 3,500 Unit dose

Phase 3, double-blind, placebo-controlled, single-treatment efficacy and safety study

  • 187 patients enrolled
  • 3 dose arms: 2,500 Units (n=63) or 3,500 Units (n=64) versus matching placebo (n=60)
  • Objectives: Determine efficacy, safety, and tolerability over a 13-week period
  • Primary efficacy measures: Unstimulated Salivary Flow Rate (USFR) and Clinical Global Impression of Change (CGI-C) at Week 4

Efficacy was consistently demonstrated across a range of objective and subjective outcome measures by both clinicians and patients5

patient’s global impression of severity (Pgi-s) pgi-s scale
patient’s global impression of Change (Pgi-c) pgi-c scale
Drooling impact score (dis) dis scale
Drooling frequency and severity scale (dfss) dfss scale


Phase 3, open-label (OL), multiple-treatment extension study

  • 170 patients enrolled
  • Patients received up to 4 additional treatment sessions over 1 year
  • Objectives: Assess duration of efficacy, safety, and tolerability over a maximum of 65 weeks

Efficacy maintained at subsequent dosing of 3,500 Units for over 1 year5

Study 2

Phase 2, multicenter, double-blind, placebo-controlled, sequential dose-escalation study

  • 54 patients enrolled
  • 4 dose arms: 1,500 Units (n=14); 2,500 Units (n=12); or 3,500 Units (n=13) versus matching placebo (n=15)
  • Patients were followed for up to 20 weeks after injection
  • Primary outcome measure: Safety and tolerability
  • All efficacy measures were considered secondary
    • USFR and CGI-C were measured at Week 4 and other selected time points
Significant reduction in USFR and CGI-C at Week 4 for all 3 dosage groups of MYOBLOC as compared to placebo1,2

1. MYOBLOC® US Prescribing Information. Solstice Neurosciences, LLC; Louisville, KY: 2019. 2. Chinnapongse R, Gullo K, Nemeth P, Zhang Y, Griggs L. Safety and efficacy of botulinum toxin type B for treatment of sialorrhea in Parkinson’s disease: a prospective double-blind trial. Mov Disord. 2012;27(2):219–226. 3. Arezzo JC. NeuroBloc®/Myobloc®: unique features and findings. Toxicon. 2009;54(5):690–696. 4. Guidubaldi A, Fasano A, Ialongo T, Piano C, Pompili M, Mascianà R, et al. Botulinum toxin A versus B in sialorrhea: a prospective, randomized, double-blind, crossover pilot study in patients with amyotrophic lateral sclerosis or Parkinson’s disease. Mov Disord. 2011;26(2):313–319. 5. Data on file. Solstice Neurosciences, LLC; Louisville, KY: 2019.


MYOBLOC® (rimabotulinumtoxinB) injection is indicated for:

  • the treatment of cervical dystonia (CD) to reduce the severity of abnormal head position and neck pain associated with CD in adults
  • the treatment of chronic sialorrhea in adults



See full prescribing information for complete boxed WARNING.

The effects of MYOBLOC® 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 an underlying condition that would predispose them to these symptoms.


MYOBLOC is contraindicated in patients with:

  • A known hypersensitivity to any botulinum toxin product or to any of the components in the formulation
  • Infection at the proposed injection site(s)


Lack of Interchangeability Between Botulinum Toxin Products
The potency units of MYOBLOC are specific to the preparation and biological activity assay method utilized. Due to differences in the aspects of this assay such as the vehicle, dilution scheme, and laboratory protocols for various potency assays, potency units are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of MYOBLOC cannot be compared to or converted into units of any other botulinum toxin products assessed with any other specific assay method.

Hypersensitivity Reactions
Serious hypersensitivity reactions have been reported with botulinum toxin products. Angioedema, urticaria, and rash have occurred with MYOBLOC treatment. Hypersensitivity reactions can also include anaphylaxis, serum sickness, soft tissue edema, and dyspnea. If serious and/or immediate hypersensitivity reactions occur, discontinue further injection of MYOBLOC and institute appropriate medical therapy immediately. The use of MYOBLOC in patients with a known hypersensitivity to any botulinum neurotoxin or to any of the excipients (human albumin, sucrose), could lead to a life-threatening allergic reaction.

Dysphagia and Breathing Difficulties
Treatment with MYOBLOC 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. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or swallowing. When distant effects occur, additional respiratory muscles may be involved. Deaths as a complication of severe dysphagia have been reported after treatment with botulinum toxin. Dysphagia may persist for several months and require use of a feeding tube to maintain adequate nutrition and hydration. Aspiration may result from severe dysphagia and is a particular risk when treating patients in whom swallowing or respiratory function is already compromised.

Cervical Dystonia:
Treatment of cervical dystonia with botulinum toxins may weaken neck muscles that serve as accessory muscles of ventilation. This may result in a critical loss of breathing capacity in patients with respiratory disorders who may have become dependent upon these accessory muscles. There have been postmarketing reports of serious breathing difficulties, including respiratory failure, in cervical dystonia patients. Patients treated with botulinum toxin may require immediate medical attention should they develop problems with swallowing, speech or respiratory disorders. These reactions can occur within hours to weeks after injection with botulinum toxin.

Pre-Existing Neuromuscular Disorders
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 MYOBLOC.

Human Albumin and Transmission of Viral Diseases
This product contains albumin, a derivative of human blood. 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 be considered extremely remote. No cases of transmission of viral diseases, CJD, or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

MOST COMMON ADVERSE REACTIONS (>5% of patients and >5% more than placebo)

Cervical Dystonia: dry mouth, dysphagia, injection site pain, headache
Sialorrhea: dry mouth, dysphagia


Co-administration of MYOBLOC and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of MYOBLOC 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. Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of MYOBLOC.

To report SUSPECTED ADVERSE REACTIONS or product complaints, contact Supernus Pharmaceuticals, Inc. at 1-888-461-2255, Option 2. You may also report SUSPECTED ADVERSE REACTIONS to the FDA at 1-800-FDA-1088 or

Please see the full Prescribing Information, including Boxed WARNING and Medication Guide.