In July 2018, the U.S. Food and Drug Administration (FDA) approved Xeomin (incobotulinumtoxinA) for chronic or excessive drooling (sialorrhea). Because people with Parkinson's swallow less frequently, saliva may build up and drooling may occur, especially later in the disease. This can be embarrassing, limit social interactions and irritate skin.
Xeomin is made from the bacteria that causes botulism (an infectious illness that causes weakness). It is injected into the glands that make saliva to temporarily block saliva production.
In contrast to an oral medication, Xeomin has less potential for general, whole-body side effects and doesn’t need to be taken every day. It typically starts working within about one week and lasts approximately three months.
Cons and Complications
Xeomin requires an injection every few months because the effects are temporary. Common side effects include bruising, pain, bleeding and swelling at the injection site. Because it decreases saliva production, it causes dry mouth and could lead to dental problems, such as tooth decay.
Xeomin also can cause weakness in muscles, such as those used for chewing, near the salivary glands. In rare cases, the botulinum toxin in the drug can spread to other areas of the body, causing swallowing or breathing problems.