Nabota, a botulinum toxin type A product, has gained popularity in the aesthetic and medical fields due to its efficacy, safety, and affordability. The 100-unit vial of Nabota is widely used for both cosmetic and therapeutic purposes, including facial wrinkle reduction, hyperhidrosis management, and muscle spasticity treatment. To ensure consistent results and patient safety, proper dilution is crucial.
Nabota is produced by Daewoong Pharmaceutical and has been approved in multiple countries for its high purity and reliable potency. Like other botulinum toxin products, Nabota works by temporarily blocking nerve signals to the muscles, reducing muscle activity and leading to smoother skin or relief from certain medical conditions.
The 100-unit vial of Nabota contains lyophilized powder that needs to be reconstituted with a sterile, preservative-free saline solution before it can be administered. The dilution ratio depends on the intended use, with different procedures requiring varying concentrations. For example, facial wrinkles typically need lower concentrations, while conditions like hyperhidrosis may require higher volumes.
Nabota 100 units vial (lyophilized powder)
Sterile, preservative-free 0.9% normal saline
1 mL or 3 mL syringe with a 21-27 gauge needle
Alcohol swabs
Sterile gloves
Clean workspace
Hygiene is paramount when handling botulinum toxin products. Ensure you are working in a clean environment with minimal contamination risk. Wash your hands thoroughly and wear sterile gloves. Clean the top of the Nabota vial with an alcohol swab and allow it to dry.
The appropriate dilution depends on the treatment area and the desired effect. Here are some common dilution ratios:
Facial Wrinkles (Glabellar Lines, Crow’s Feet): 2.0 mL saline to 100 units (resulting in 5 units per 0.1 mL)
Masseter Reduction (Jawline Slimming): 1.5 mL saline to 100 units (resulting in 6.67 units per 0.1 mL)
Hyperhidrosis (Excessive Sweating): 4.0 mL saline to 100 units (resulting in 2.5 units per 0.1 mL)
Spasticity or Dystonia: Dilution can vary significantly based on the target muscle groups, typically between 1.0 mL to 8.0 mL of saline.
Using a sterile syringe, draw up the required amount of sterile saline solution based on the chosen dilution ratio.
Insert the needle into the Nabota vial at a slight angle to avoid damaging the rubber stopper. Slowly inject the saline into the vial. The slower the injection, the less agitation and foaming occur, preserving the potency of the product.
Once all the saline is added, gently swirl the vial. Avoid shaking the vial vigorously, as this can degrade the botulinum toxin and reduce its effectiveness.
After reconstitution, check the solution for clarity. It should be free of particles and completely transparent. If you notice any cloudiness, particulate matter, or discoloration, the solution should be discarded.
Once the solution is properly mixed, use a sterile syringe to draw up the appropriate amount of the reconstituted Nabota solution based on the required dosage for the treatment area. Depending on the procedure, you may need multiple syringes if you’re treating multiple areas.
Administering botulinum toxin requires precision and expertise. Injection techniques vary depending on the treatment area:
For facial wrinkles, such as glabellar lines, inject the solution intramuscularly, targeting the specific muscles responsible for the dynamic wrinkles.
For masseter reduction, inject into the thickest part of the masseter muscle, typically at multiple points to ensure even distribution.
For hyperhidrosis, use multiple superficial injections across the affected area, such as the underarms or palms.
Ensure that you follow appropriate injection techniques, including proper depth, angle, and speed, to achieve optimal results while minimizing side effects like bruising or ptosis.
After the procedure, provide patients with guidelines for post-treatment care. Advise them to avoid rubbing the treated area, engaging in vigorous exercise, or lying down for at least four hours to prevent the toxin from migrating to unintended areas. Patients should also be informed that results typically start appearing within 3-7 days, with full effects visible at around two weeks.
Storage: Unreconstituted Nabota vials should be stored in a refrigerator at 2-8°C. Once diluted, it is recommended to use the solution within 24 hours. If necessary, it can be stored in the refrigerator, but potency might decrease over time.
Allergic Reactions: Although rare, allergic reactions to botulinum toxin can occur. Always review the patient’s medical history for contraindications, such as previous reactions or neuromuscular disorders.
Side Effects: Common side effects include mild bruising, pain at the injection site, and temporary muscle weakness. More serious but rare complications include drooping eyelids or asymmetry. Proper dilution and injection technique reduce the likelihood of adverse effects.
Patient Education: Make sure patients have realistic expectations and understand that botulinum toxin effects are temporary, typically lasting 3-6 months.
Proper dilution of Nabota 100 units is essential for achieving consistent, safe, and effective results. By following this step-by-step guide, practitioners can ensure optimal outcomes for both cosmetic and therapeutic procedures. As with any botulinum toxin product, understanding the anatomy, mastering injection techniques, and adhering to safety protocols are key to successful treatment. Always stay updated with training and guidelines to provide the best care for your patients.