Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Distant toxin spread: Very rarely, this medication may spread to other parts of the body other than where it was injected, leading to muscle weakness, difficulty swallowing, pneumonia, speech difficulties, and breathing problems. Distant toxin spread can be fatal. If you develop severe difficulty swallowing, speaking, or breathing while using this medication, contact your doctor immediately. This medication should be used with caution in people who have pre-existing swallowing, breathing, or nerve problems.
Heart problems: There have been rare reports of heart problems such as irregular heart rhythms and heart attack following injection of this medication. If you have heart disease discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Other medical conditions: People with amyotrophic lateral sclerosis, with disorders that produce a depletion of acetylcholine, or disorders that produce peripheral neuromuscular dysfunction should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pregnancy: This medication should be used during pregnancy only if the potential benefit justifies the potential risk to the mother and unborn baby. If you become pregnant while using this medication, contact your doctor immediately.
Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: This medication is not recommended for children.