Package leaflet - Dysport®

PACKAGE LEAFLET: INFORMATION FOR THE USER
DYSPORT® - 500 units
Powder for solution for injection
Clostridium botulinum type A toxin-haemagglutinin complex
Read all of this leaflet carefully, before you start using this medicine, because it contains important information for you.
  • Keep this leaflet. You may need to read it again.
  • If you have further questions, ask your doctor, pharmacist or nurse.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

  • What Dysport is and what it is used for
  • What you need to know before you are given Dysport
  • How Dysport is given
  • Possible side effects
  • How to store Dysport
  • Contents of the pack and other information

1. What Dysport is and what it is used for
Dysport contains the active substance Clostridium botulinum type A toxin-haemagglutinin complex.
What Dysport is used for:
Dysport is used in adults to treat muscle spasms:

  • Around the eyes
  • In the face
  • In the neck
  • In the arm and shoulders
  • In the leg.
    Dysport is used in children (aged two years or older) with cerebral palsy to treat muscle spasms in the legs, to improve their walking.
    How Dysport works:
    Dysport contains a toxin produced by the bacterium Clostridium botulinum. It works by stopping your muscles contracting. It does this by stopping the release of a chemical which acts between the nerves and muscles that makes the muscles contract. This helps to reduce abnormal muscle contractions known as spasms.

2. What you need to know before you are given Dysport Do not use Dysport:

If you are allergic to botulinum toxin type A or any of the other ingredients of this medicine (listed in section 6).
Warnings and precautions:
There are increased risks of having Dysport injections under any of these circumstances. Talk to your doctor, pharmacist or nurse before using Dysport if:
  • You have problems swallowing
  • You have any history of bronchitis, pneumonia or problems with breathing
  • You have had an allergic reaction to a botulinum toxin in the past
  • You have other problems or diseases that affect your muscles e.g. myasthenia gravis
  • Y ou bleed easily
  • You have an infection where the injection will be given or if that area is swollen.
    Children and adolescents:
    For the treatment of spasticity associated with cerebral palsy in children, Dysport should only be used in children 2 years of age or over.
    Other medicines and Dysport:
    Please tell your doctor if you are taking any antibiotics for an infection (e.g. aminoglycosides such as gentamicin or amikacin) or muscle relaxing drugs. Some of these medicines may increase the effect of Dysport.
    Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription.
    Pregnancy, breast-feeding and fertility:
    Dysport is not recommended during pregnancy, unless clearly necessary. Dysport is not recommended in breast-feeding women.
    Dysport may affect fertility, when given at high doses.
    If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
    Driving and using machines:
    Dysport may cause muscle weakness or problems with your vision.
    If you experience any of these effects, do not drive or use any machines.

3. How Dysport is given
Your doctor will choose your dose of medicine, and decide how often you need treatment. This will depend on what you are being treated for.
A vial of Dysport should be used only for you and only for a single treatment session.
For treatment of muscle spasms in your arm and shoulder:
The dose of Dysport will usually be between 500 and 1000 units divided between the affected arm and shoulder muscles. Your muscle spasms should normally improve within 1 week.
Injections will usually be given about every 12 to 16 weeks.

 
For treatment of muscle spasms in your leg:
The dose of Dysport will usually be 1500 units and should not exceed this dose. The doctor may divide the amount between the affected leg muscles.
Injections will usually be given about every 12 to 16 weeks.
For treatment of muscle spasms in your arm and leg:
If you need to receive injections in your arm and leg in the same treatment session, your doctor may divide the dose between your arm and leg in line with the approved dose recommendations, but the overall dose must not exceed 1500 units.
For treatment of muscle spasms in your neck:
The first dose of Dysport will usually be 500 units divided into a number of places in the neck, probably into 2 or 3 of the neck muscles most affected by the condition. A smaller amount may be given to very underweight or elderly patients. Your muscle spasms should improve within 1 week. Further injections (250 - 1000 units) will be given about every 16 weeks depending on how long the effect lasts or as required to maintain a response, but not more frequently than every 12 weeks. The maximum dose should not exceed 1000 units.
For treatment of muscle spasm around your eyes:
The first injection will usually be 40 units per eye. The medicine will be injected just under the skin at various sites around the eye. If only one eye is affected, the doctor will only give injections of Dysport around this eye. Injections will be given about every 12 weeks depending on how long the effects last. On the next visits, the amount of Dysport given may be increased to a maximum of 120 units per eye.
For treatment of muscle spasm in your face:
The doctor will give you injections on the side of your face that is affected. The first injection will usually be 120 units. Injections will be given about every 12 weeks depending on how long the effects last. Your next injections of Dysport may be reduced to 80 or 60 units.
For treatment of muscle spasms in the legs of children with cerebral palsy:
Children over 2 years: The dose is decided by your doctor. Dysport is injected into the affected muscles of the legs. The dose must not be higher than 1000 units or 30 units/kg at a given treatment session. Your doctor will repeat the treatment approximately every 16 - 22 weeks or as needed, but no more frequently than every 12 weeks.
If you are given more Dysport than you need
If you are given more Dysport than you need, muscles other than the ones that were injected may begin to feel weak. This may not happen straight away. If this does happen, speak to your doctor immediately. Seek urgent medical help if you have difficulty breathing, swallowing or speaking.
If you forget an injection of Dysport
Nothing will happen if an injection is missed other than some of the spasm or muscle stiffness may return. Tell your doctor and he will decide when the next injection is needed.
If you stop taking Dysport
Your muscle spasms will return to the way they were before treatment.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
 
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Dysport may in rare cases cause side effects away from its site of injection.
Seek urgent medical help if:
  • You have any problems swallowing, breathing or with your speech or you have worsened muscle weakness.
  • You develop difficulty in breathing with or without swelling of the face, lips, tongue and/or throat, redness of the skin or an itchy lumpy rash (urticaria). This may mean you are having an allergic reaction to Dysport.
    Some side effects may occur in any patient treated with Dysport whilst other side effects may depend on the condition being treated.
    Make sure you read all the sections that apply to you.
    Treatment of any condition (all patients): Common: may affect up to 1 in 10 people
    • Bruising, or pain around the site where the injection was given
    • Generalised weakness
    • Tiredness

Flu-like symptoms.
Uncommon: may affect up to 1 in 100 people  Itching.
Rare: may affect up to 1 in 1,000 people

  • Skin rashes
  • Sudden severe pain and weakness in shoulder and/or arm (neuralgic amyotrophy).
    Treatment of muscle spasms in the arm and shoulder: Common: may affect up to 1 in 10 people
  • Muscle weakness
  • Musculoskeletal pain.
    Uncommon: may affect up to 1 in 100 people
    Difficulty in swallowing

    Pain in the hands and fingers.
    Treatment of muscle spasms in the leg: Common: may affect up to 1 in 10 people

    Difficulty in swallowing

  • Leg muscle weakness
  • Muscle pain
  • Fall.
    Treatment of muscle spasms in the eyes or face: Very common: may affect more than 1 in 10 people

Drooping of the upper eyelid. Common: may affect up to 1 in 10 people

  • Double vision
  • Swelling of the eyelid
  • Facial muscle weakness
  • Dry eyes or more tears than usual. Uncommon: may affect up to 1 in 100 people
  • Facial paralysis.
Rare: may affect up to 1 in 1,000 people
  • Difficulty in moving the eye
  • Edge of the eyelid turning in towards the eyeball (entropion).
    Treatment of muscle spasms in the neck:
    Very common: may affect more than 1 in 10 people
  • Muscle weakness
  • Difficulty in swallowing. This side effect may be expected to resolve within 2 to 4 weeks
  • Dry mouth.
    Common: may affect up to 1 in 10 people
  • Headache
  • Dizziness
  • Blurred vision or other problems in seeing clearly
  • Weakness of face muscles
  • Stiff muscles
  • Shortness of breath
  • A change to the tone of the voice
  • Neck pain, muscle pain, pain in the hands and fingers.
    Uncommon: may affect up to 1 in 100 people
  • Loss of muscle tissue
  • Jaw problems
  • Drooping of the upper eyelid
  • Double vision
  • Nausea.
    Rare: may effect up to 1 in 1,000 people

Lung inflammation caused by accidentally breathing in food, drink, saliva or vomit (aspiration pneumonia).
Treatment of muscle spasms in the legs of children with cerebral palsy: Common: may affect up to 1 in 10 people

  • Muscle pain
  • Muscle weakness
  • Urinary incontinence
  • Influenza-like illness
  • Pain, redness, bruising at the injection site
  • Abnormal walking
  • Tiredness
  • Fall.
    Uncommon:
  • Loss of strength and weakness.

Reporting of side effects

 
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Dysport
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the label after ‘EXP’. The expiry date refers to the last day of that month.
Store in a refrigerator (2°C - 8°C). Do not freeze.
Chemical and physical in-use stability has been demonstrated for the reconstituted solution for 24 hours in a refrigerator (2°C - 8°C). After the solution is made up, unless the method of reconstitution precludes the risk of microbial contamination, the product should be used immediately. If not used immediately, in- use storage times and conditions prior to use are the responsibility of the user.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Dysport contains
The active constituent of Dysport is Clostridium botulinum type A toxin-haemagglutinin complex (500 units).
The other excipients in Dysport are human albumin and lactose.
Before it is injected, Dysport will be dissolved in sodium chloride for injection (a solution of salt).
What Dysport looks like and contents of the pack
Dysport is a powder for solution for injection. It appears as a white powder in a glass vial. It comes in pack sizes of 1 or 2 vials, although not all pack sizes may be marketed.
Dysport is also available in 300 unit vials.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Ipsen Limited, 190 Bath Road, Slough, Berkshire, SL1 3XE, UK.
Manufacturer:
Ipsen Biopharm Limited, Ash Road, Wrexham Industrial Estate, Wrexham LL13 9UF.
Is this leaflet hard to see or read? Please phone +44 (0) 1753 627777 and ask for help. This leaflet was last revised in February 2017.