Drug General Information (ID: DDIG4YF3T7)
Drug Name			Botulinum Toxin Type B		Drug Info		Orphenadrine		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Antidystonic Agents				Antiparkinson Agents

Mechanism of Botulinum Toxin Type B-Orphenadrine Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Botulinum Toxin Type B				Orphenadrine
Mechanism		Neuromuscular blocking effects				Neuromuscular blocking effects
Key Mechanism Factor 1
		Factor Name		Neuromuscular blocking effects
		Factor Description		Neuromuscular blocking agents cause paralysis of affected skeletal muscles by blocking postsynaptic acetylcholine (Nm) receptors, thereby blocking neuromuscular signaling at the neuromuscular junction. Neuromuscular blocking agents can cause the following side effects: muscle paralysis, jaw stiffness, and shortness of breath. Concomitant use of drugs with neuromuscular blocking activity may result in severe and/or prolonged respiratory depression.
Mechanism Description		Additive neuromuscular blocking effects by the combination of Botulinum Toxin Type B and Orphenadrine

Recommended Action
Management		Patients should be advised that muscle weakness may be increased when botulinum toxin is used in combination with skeletal muscle relaxants.

References
1	Product Information. Myobloc (botulinum toxin type B) Elan Pharmaceuticals, S. San Francisco, CA.
2	Product Information. Xeomin (botulinum toxin type A (obsolete) (botulinum toxin type A)). Merz Pharmaceuticals, Greensboro, NC.
3	Product Information. Dysport (abobotulinumtoxinA). Tercica Inc, Brisbane, CA.