| Summary: | The four Botulinum neurotoxin type A (BoNT-A) products have different complex protein structures and differ in their molecular weights, pharmacologic profiles, and potency. Because each BoNT-A product has a different potency, they are not considered interchangeable by Health Canada and dosages may not covert directly on a 1 to 1 basis. Each BoNT-A has a different nonproprietary name (generic name) to make it more clear that the products are not interchangeable. However, switching may be necessary for patients who experience secondary nonresponse, develop side effects, or are required to do so for reasons related to drug coverage. For these reasons, it is important to be aware of the evidence to support the efficacy of switching between different BoNT-A products in experienced users. This report will review the evidence of clinical effectiveness of switching BoNT-A products for patients with upper limb spasticity (ULS) and cervical dystonia (CD)
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