Let me introduce myself, lantox! What do we know about the new hero of aesthetic medicine?

The drug Lantox is a botulinum toxin type A drug, the action of which is to block the transmission of nerve impulses from the central nervous system to the muscle. As a result of the action of botulinum toxin, the overstrained muscle relaxes and the pain syndrome caused by muscle spasm stops. Lantox acts locally, without having a systemic effect on the entire body, so its use is safe. In dentistry, Lantox is used for pain caused by increased muscle tone, to treat bruxism, to normalize the functioning of the temporomandibular joints, etc., just like the drug Botox.

History and description of the drug

The cosmetic product was created by a specialist from China, Dr. Inchun Wang. This happened in 1988, after four years of research on Clostridium Botulinum cultures.

After laboratory tests in 1997, the necessary license and certification for the manufacture of drugs with the Lantox brand was obtained. The production was undertaken by the Lanzhou Institute of Biological Products. Four years later, GMP certification was obtained, which confirms the high quality of the products.

Note! To date, this drug is supplied to 10 countries. So, in Russia its use began in 2008.

Lantox is successfully used in Russia

Since its inception, many patients have successfully used Lantox in various fields of medicine (from ophthalmology and gynecology to cosmetology). There are a large number of clinical studies confirming that the drug is safe and has a high level of effectiveness.

Release form: bottles of 50 and 100 units, the medicine has the form of a white powder, with the help of which a solution for injections is produced. Additional auxiliary ingredients: gelatin, dextran, sucrose. At the same time, gelatin makes the neurotoxin molecules themselves stronger, which reduces the penetration of the drug into neighboring tissues - due to this, the dose used is significantly reduced, and the accuracy of the action of the active substance on muscle fibers is selective and high.

Bottles of 50 and 100 units are available

This medical technology “Treatment of neurogenic detrusor overactivity and detrusor-sphincter dyssynergia with Lantox” considers methods of treating neurogenic urinary dysfunction, manifested by detrusor overactivity and detrusor-sphincter dyssynergia, by local administration of the drug Lantox (botulinum toxin type A). It contains a description of the technique for administering Lantox, the protocol of the procedure, material and technical equipment, indications and contraindications for this method of treatment; complications, measures for their prevention and treatment, the effectiveness of the method is shown. The protocol and technique of the procedure are given.

Level/scale of use: institutions licensed for medical activities according to the nomenclature of work and services, work and services in urology, neurology, surgery, gynecology.

The technology is intended for doctors: urologists, neurologists, surgeons, gynecologists who have undergone thematic improvement and mastered the method of using this technology.

Applicant and developer of technology: Nike-Med LLC, Russia, Moscow.

Co-developer: Moscow Medical Academy named after. THEM. Sechenov; Federal State Institution "Research Institute of Urology of Rosmedtekhnologii", Russia, Moscow; OJSC Rehabilitation.

INTRODUCTION

Drug therapy is leading in the treatment of functional urination disorders. However, it does not always fully meet the criteria for the effectiveness and tolerability of drugs. This leads to both the search for new formulas of medicinal substances with selective action, as well as new dosage forms and methods of their administration.

A striking example of the achievements of modern pharmacopoeia is the development and successful use of botulinum toxin (BT) preparations. BT is one of the most powerful biological poisons known to mankind. As a long-acting local muscle relaxant, the neurotoxin has found its use in many branches of medicine, including urology, neurourology, and urogynecology.

For the first time in urological practice, BT was used by D. Dykstra et al. (1988) for the treatment of detrusor-sphincter dyssynergia in patients with traumatic spinal cord disease. BT has found its use in the treatment of overactive bladder syndrome, interstitial cystitis, chronic pelvic pain syndrome due to hypertonicity of the pelvic floor muscles with symptoms of vaginismus, and spasm of the rectal sphincters.

The BT molecule consists of a neurotoxin and non-toxic non-hemagglutinin and hemagglutinin, which, having a large molecular weight, prevent both the breakdown of the neurotoxin and its rapid diffusion into surrounding tissues, ensuring localized effects. The neurotoxin consists of a heavy (molecular weight 100 kDa) and light (molecular weight 50 kDa) chains connected by one disulfide group and one zinc atom. The heavy chain binds to specific receptors located on the surface of target neurons. The light chain cleaves a specific region of the complex of transport proteins that transport acetylcholine vesicles to the presynaptic membrane. The main ones are SNAP-25, syntaxin, synaptobrevin. Once in the cytosol, different BT serotypes cleave different substrates. Type A is recognized as the most powerful of the botulinum toxins. The light chain of botulinum toxin type A has Zn2+-dependent protease activity, specific to the cytoplasmic regions of the synaptosomal-associated protein SNAP-25. The molecular weight of BT (150 kDa) makes it impossible for it to penetrate the blood-brain and placental barriers.

The clinical effect after BT injection does not appear immediately, but after a few days. This is due to the fact that the process of introducing the toxin into the presynaptic terminal and blocking Q of the presynaptic membrane takes from 1 to 3 days (J. Moore, 1995).

BT has a dose-dependent effect, which allows, with the correct selection of the dose and injection points, to achieve partial chemical denervation that is not accompanied by dysfunction of the muscle (organ).

In 1996, Lantox, a drug containing botulinum toxin type A stabilized with gelatin, entered clinical practice. Thanks to the use of gelatin as a stabilizer for the BTA molecule, this drug achieves greater strength of the three-dimensional structure of the botulinum toxin molecule compared to other drugs in this group. This structure of Lantox is of decisive importance for increasing the stability of botulinum toxin type A and reducing unwanted diffusion of the drug, which, in turn, makes it possible to reduce the doses of Lantox used and ensures the selectivity of its local action. The advantages of the drug Lantox, which make it convenient for practical use in urology compared to other drugs containing botulinum toxin type A, are more convenient packaging of the drug in 50 and 100 units in a bottle, shelf life 3 years (at temperatures from -20° From to -5°C).

Neurogenic bladder dysfunction is a collective concept that characterizes disorders of voluntary urination due to damage to the peripheral and central nervous system. Manifestations of neurogenic urinary dysfunction are quite varied, from complete urinary incontinence to urinary retention. All the variety of forms of manifestations of violations of evacuation and reservoir functions in neurogenic dysfunction of the bladder is associated with a variety of options for damage to the nervous system. But at the same time, all these lesions are united by the common symptom of impaired voluntary urination.

Neurogenic detrusor overactivity is overactive bladder syndrome, which is a manifestation of a neurological disease. It is characterized by urgent urination, increased frequency of daytime urination more than 8 times a day, nocturia (frequent urination from the moment of falling asleep until waking up), and urgent urinary incontinence. This condition often occurs in patients with multiple sclerosis, myelodysplasia, after spinal and cerebral stroke, vertebral disorders, neuroinfection, surgery on the pelvic organs, spinal cord injury, etc.

Detrusor-sphincter dyssynergia is a consequence of a violation of the reciprocal relationship between the sphincters and detrusor, which occurs when there is a disruption in the connection between the spinal centers of urination and the centers of miction in the brain. There are external and internal detrusor-sphincter dyssynergia. External detrusorosphincteric dyssynergia is manifested by involuntary contraction of the external urethral sphincter at the time of detrusor contraction during the bladder emptying phase, and is usually accompanied by spasticity of the pelvic floor muscles. Internal detrusorosphincteric dyssynergia occurs due to dyssynergia of the detrusor with the internal urethral sphincter and is a consequence of hyperactivity of the thoracolumbar sympathetic centers and more often occurs with lesions of the upper spinal cord.

Indications for the use of medical technology

Neurogenic dysfunction of urination, manifested by detrusor hyperactivity and detrusorosphincteric dyssynergia and leading to disruption of the reservoir and evacuation functions of the bladder:

• overactive bladder;
• detrusor-sphincter dyssynergia.

Contraindications:

• myasthenic, myasthenic-like syndromes;
• acute cystitis, acute urethritis;
• acute prostatitis, acute epididymo-orchitis;
• high degree of myopathy;
• pregnancy, breastfeeding period;
• hemophilia.

Relative contraindications and restrictions:

• history of allergies (especially to drugs containing proteins);
• taking antibiotics from the aminoglycoside group (gentamicin, kanamycin, erythromycin, streptomycin), tetracycline, lincomycin, polymyxins, which enhance the effect of the toxin (if more than 2 weeks have not passed after the course of treatment); drugs that increase intracellular calcium concentration (aminopyridine, etc.); benzodiazepines; baclofen and other muscle relaxants; aspirin and other anticoagulant and antiplatelet drugs, cyclosporine; D-penicillamine;
• alcohol abuse;
• chronic diseases of the cardiovascular system, respiratory organs, kidneys, and other organs and systems in the compensation stage;
• previous operations on the pelvic organs, accompanied by denervation of the muscles of the urinary system.

Logistics support for medical technology:

• urological endoscopic room corresponding to SanPiN 2.1.3.1375-03;
• sodium chloride solution 0.9% (for preparing drug solutions) in 10 ml ampoules (RU FS P No. 015784/01);
• sterile rubber medical gloves (according to DIN BS 4005/EN 455/ASTM D-3577 standards), cotton balls or disks, napkins (GOST 16427-93), rubber ice packs;
• container for disposal of used bottles and consumables;
• means for disinfecting skin, rubber gloves;
• sodium hypochlorite solution to neutralize drug residues (RU FS P No. 015784/01);
• sterile gauze wipes, disposable sheets to delimit the area of ​​the procedure;
• disposable cap, gown and shoe covers for the doctor and patient;
• anti-shock first aid kit;
• portable electromyograph (“Neurotech”) for injection of botulinum toxin preparations;
• the drug Lantox is a drug of botulinum toxin type A in the form of a lyophilisate for the preparation of a solution for injection, manufacturer Lanzhou Institute of Biological Products (RU FS No. LSR-001587/08 dated March 14, 2008), in bottles of 50, 100 units.

Storage conditions for the drug Lantox

The closed bottle of Lantox should be stored and transported at a temperature of 20°C to 5°C. Shelf life: 3 years. The drug is a white powder, tasteless and odorless, without foreign inclusions.

Storage conditions for the diluted drug: Lantox solution should be used immediately after dilution or stored in the refrigerator at a temperature of +2 to +8 degrees for no more than 4 hours.

Accounting for the drug Lantox

Lantox preparations are subject to strict accounting and special storage. To do this, it is registered in a special accounting book and given to the doctor strictly against signature.

The outpatient card records: the administered dose, injection points, series, shelf life of the drug, and used bottles must be stored for 1 month.

Lantox is stored in a separate closed, labeled box in the freezer compartment of the refrigerator of the medical institution where injections of the drug are carried out.

The drug cannot be given to the patient for storage.

DESCRIPTION OF MEDICAL TECHNOLOGY

Treatment technology with Lantox, botulinum toxin type A, includes three stages:

• preparatory: preparing the patient for treatment;
• main: botulinum therapy procedure;
• final: compliance with the medical and protective regime and the basic principles of home care.

At the first (preparatory) stage of providing medical services, it is necessary to:

• conclude an agreement on the provision of medical services between a medical institution represented by its representative and the patient;
• assess the patient’s general health, make sure there are no absolute and relative contraindications to the procedure (both general and local);
• obtain the patient's informed consent for the upcoming procedure, which reflects information about the mechanism of action and duration of action of Lantox, possible complications, and the need to adhere to the recommended regimen.
• ensure strict medical supervision when treating patients with chronic diseases of the heart, liver, lungs, and blood in the compensation stage with Lantox.

The patient usually does not require special preparation before undergoing the procedure. It is important to conduct a general clinical examination, including a general blood and urine test, a biochemical blood test with a coagulogram, a blood test to detect antibodies to HIV and hepatitis C. When administering the drug endoscopically and during intravenous anesthesia, the examination is supplemented by consultation with a therapist. Immediately before the procedure, the patient requires a cleansing enema and shaving of the genitals.

The second (main) stage of treatment consists of four procedures:

• dilution of the drug Lantox;
• implementation of the treatment program: direct use of the drug Lantox;
• drawing up a protocol of the procedure;
• Conducting a final assessment of the achieved treatment result.

The procedure for administering Lantox for neurogenic detrusor overactivity:

• the patient is in the urological chair in the lithotomy position;
• dilution of the drug Lantox: 300 units of the drug Lantox are diluted in 30 ml of 0.9% sterile saline solution;
• treatment of genitals with antiseptic solutions;
• conducting observation urethrocystoscopy;
• injection of a solution of the drug Lantox into the wall of the bladder using an endoscopic injection needle inserted through the working channel of a cystoscope. Injections are carried out under constant visual control at 30 points of the bladder, with the exception of the area of ​​Lietto's triangle, the needle is inserted to a depth of 0.5 cm. The drug solution is injected in 1 ml doses at the rate of 10 units per 1 injection point;
• after the injection, the condition of the bladder wall is assessed, the presence of hematuria;
• the procedure is completed by installing a urethral catheter for a period of 2-3 to 24 hours.

For detrusorosphincteric dyssynergia:

• the patient is in the urological chair in the lithotomy position;
• dilution of the drug Lantox: when administered transperineally into the external urethral sphincter, the drug is diluted at the rate of 50 units per 4 ml of 0.9% sterile saline; with the endoscopic method of administration, 100 units of Lantox are diluted into 8 ml of 0.9% sterile saline solution;
• treatment of genitals with antiseptic solutions;
• for transperineal injection, Lantox solution is administered through a special needle electrode with an insulating Teflon coating. The needle is an active electrode. The passive electrode is placed on the patient's thigh. The non-insulated tip of the needle acts as an electrode; its position in the perineal muscles is controlled using electromyography by the characteristic sound of the electromyograph speaker;
• in women, the transperineal route of administration of Lantox into the external urethral sphincter is the most preferable. The needle is inserted under the control of the index finger inserted into the vagina, to a point located 1 cm lateral and above the external opening of the urethra (2 and 10 o'clock according to the conventional dial) to a depth of 1.5-2.0 cm. As experience is gained, transperineal insertion can be performed without electromyographic control. 25 units of the drug in 2 ml of 0.9% sterile saline solution or 50 units of the drug in 4 ml of 0.9% sterile saline solution are injected into each point;
• transperineal injections of Lantox in men are carried out under the control of the index finger inserted into the rectum and resting on the apex of the prostate, under which is the striated urethral sphincter. The needle is inserted into a point located 2 cm lateral and above the anal sphincter on both sides. The tip of the needle should be in close proximity to the apex of the prostate gland. 25 units of the drug in 2 ml of 0.9% sterile saline solution or 50 units of the drug in 4 ml of 0.9% sterile saline solution are injected into each point;
• for spasticity of the perineal muscles, manifested by vaginismus, anismus or anal fissure, the drug is also administered transperineally. For vaginismus, a dose of 30-50 units into the anterior vaginal wall. For anism (pathological spasm of the puborectal muscle) in a dose of 25-50 units into each puborectal muscle on both sides. For anal fissure, Lantox injection is carried out into the anterior part of the internal anal sphincter in a dose of 20 units;
• with the endoscopic method, the procedure begins with observation urethrocystoscopy, visualization of the external sphincter of the bladder. Urethroscopy determines the area of ​​the striated urethral sphincter. Its endoscopic visualization in men usually does not cause difficulties; the sphincter is located immediately behind the apical part of the prostate (the seminal tubercle can serve as a reference point) and is defined as a section of the urethra with a tonic wall that contracts when irritated by an instrument like a muscle sphincter. It is more difficult to reliably determine the external sphincter zone in women, since it is much shorter and wider than the male one. The reference point for women is the neck of the bladder, distal from which, at a distance of 1.0-1.5 cm, the sphincter zone is determined. To make it easier to locate the sphincter and manipulate the female urethra, you can insert your index finger into the vagina and press its front wall against the endoscope.
• To administer Lantox into the external urethral sphincter, use 4 points, evenly distributing the dose of the drug between them (at 3, 6, 9 and 12 o’clock). Thus, 2 ml of Lantox solution, 25 units, is injected into each point;
• removal of the urethroscope and completion of the procedure;
• The procedure ends with the installation of a urethral catheter for up to 24 hours.

Repeated administration of Lantox is recommended after 4-6 months, but not earlier than 2 months from the date of the last administration of the drug.

Third, final stage

Compliance with the medical and protective regime and the basic principles of home care.

The postoperative period usually proceeds smoothly. After administering BT drugs, it is recommended to cool the injection area, as well as intensively strain the injected muscles for 15-30 minutes after the procedure. After transurethral administration of BT, it is recommended to install a urethral catheter for 1 day. An important point is the need for close dynamic monitoring of the patient for 1 hour after injection due to the risk of developing allergic reactions to the protein component of BT drugs.

The third stage of treatment is no less important than the previous two. The patient's compliance with the doctor's requirements for compliance with the regimen and rules of home care after the administration of Lantox largely determines the prevention of adverse events, the effectiveness of treatment and the duration of the achieved effect.

Adverse reactions and complications when using medical technology and ways to eliminate them:

• decreased contractility of the detrusor, up to acute urinary retention;
• urinary incontinence;
• hematuria;
• pain at the injection site;
• exacerbation of urinary tract infection.

Ways to eliminate complications:

• in case of an overdose of the drug, constant medical monitoring of the dynamics of symptoms and the prescription of anticholinesterase drugs are required;
• in case of acute urinary retention, it is necessary to install a permanent catheter in the bladder for 24 hours and prescribe I-receptor blockers, then transfer to intermittent autocatheterization. If the contractility of the bladder decreases with the appearance of residual urine (more than 100 ml), it is necessary to take a1 receptor blockers, including intermittent autocatheterization;
• transient symptoms of stress urinary incontinence disappear within 2-3 days;
• hematuria requires drainage of the bladder with a urethral catheter for a period of 1 to 3 days and the prescription of hemostatic agents;
• pain at the injection site is temporary and in some cases requires the prescription of non-steroidal anti-inflammatory therapy;
• urinary tract infection is eliminated according to the general rules, but drugs of the aminoglycoside and tetracycline group, which enhance the effect of the toxin, are not prescribed.

EFFECTIVENESS OF MEDICAL TECHNOLOGY

Numerous clinical trials have shown the high effectiveness of botulinum toxin administration for urological diseases (M. Naumann, Y. So et al., 2008). Thus, when introducing BT into the external urethral sphincter for the treatment of detrusor-sphincter dyssynergia, local spasm of the external urethral sphincter, detrusor hypotension, many researchers noted a significant decrease in the volume of residual urine or its disappearance (G.G. Krivoborodov, M.E. Shkolnikov, 2004; M. Phelan et al., 2001).

Urodynamically, a decrease in the average urethral pressure and average detrusor pressure, an increase in the maximum urine flow rate and effective urinary volume were noted (H. Petit et. al., 1998).

E.B. Mazo et al. (2006) used BT in 19 patients with detrusorosphincter dyssynergia. 1 month after injection, the average maximum urine flow rate increased from 5.7 to 10.3 ml/s, and the average residual urine volume decreased from 217 to 75 ml. The average detrusor pressure at maximum urine flow rate decreased from 101.5 to 65.4 cmH2O. Art. Two of the four patients who used intermittent autocatheterization began to urinate on their own.

H. Kuo (2003), having studied the effect of BT in 103 patients with chronic urinary retention of various etiologies, noted a decrease in urethral pressure, an increase in the maximum speed of urination and a decrease in detrusor pressure. A decrease in residual urine was found in 84.5% of patients.

In the work of D. Zermann et al. (2001), devoted to the treatment of chronic pelvic pain syndrome with BT injections into the external urethral sphincter, noted that in 9 out of 11 patients it was possible to significantly improve urodynamic parameters and reduce the average score of the visual analogue pain scale from 7.2 to 1.6.

The indication for the injection of botulinum toxin into the detrusor is its neurogenic and idiopathic hyperactivity. A. Reitz et al. (2004), conducting a study on 200 patients with urinary incontinence due to neurogenic detrusor overactivity, noted a significant increase in the average maximum cystometric capacity and bladder compliance 6 weeks after the administration of BT.

C. Smith et al. (2005) conducted studies on 110 patients. After the introduction of BT, 67.3% experienced a decrease or absence of urinary incontinence, a decrease in the number of episodes of urgency urinary incontinence and urinary frequency.

E.B. Mazo et al. (2006) used BT in 7 patients with detrusor hyperactivity. There was an increase in the average cystometric capacity from 95.3 to 165.8 ml, a decrease in the number of episodes of urge urinary incontinence from 4 to 1 and the frequency of urination from 22 to 12 per day.

D. Schmid et al. (2006) conducted a study of a total of 23 men and 77 women with idiopathic detrusor overactivity who were resistant to conservative treatment despite taking maximum doses of anticholinergic drugs. When examining patients 4 and 12 weeks after the administration of BT, subjective improvement was noted in 88% of patients. During the first 2 weeks after BT injections into the bladder, urgency disappeared in 82% of patients, urinary incontinence in 86%. The average frequency of daily urination decreased from 14 to 7 times, nocturia decreased from 4 to 1.5 times. Maximum bladder capacity increased by 56%, average compliance increased from 24 to 41 ml/cm2 of water. Art. The average duration of action of BT was 6 ± 2 weeks.

The above data show the high efficiency of the method, its availability, and safety.

Key words: botulinum toxin type A, urinary dysfunction.

LITERATURE

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• Morrisroe SN MD, Chancellor MB MD. Botulinum Toxin A in the Treatment of Neurogenic and Idiopathic Urinary Incontinence. 2005.
• Werner M., Kuschel S., Schmid DM, Schuessler B. Efficacy of Botulinum Toxin A in the Treatment of Female Idiopathic Detrusor Overactivity Incontinence: Long-Term Results of a Prospective Nonrandomised Study // Eur. Urol. 2006. Vol. 5. P.685-690.
• National Institute for Health and Clinical Excellence (NICE). The Management of Urinary Incontinence in Women. 2006.
• Duthie J., Wilson DI, Herbison GP, ​​Wilson D. Botulinum toxin injections for adults with overactive bladder syndrome. // Cochrane Database of Systematic Reviews. 2007. Issue 3, Art. No.: CD005493.
• MacDonald R., Fink HA, Huckabay C., Monga T., Wilt TJ Botulinum toxin for treatment of urinary incontinence due to detrusor overactivity: A systematic review of effectiveness and adverse effects. // Spinal Cord. 2007. Vol 45, No. 8. P. 535-541.
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• Ramsay AK, Small DR, Conn IG To assess the efficacy of intravesical botulinum toxin type A (BTX-A) in interstitial cystitis (IC). // Surgeon, 2007. P. 331-333.
• Schurch B., de Seze M., Denys P., Chartier-Kastler E., Haab F., Everaert K., Plante P., PerrouinVerbe B., Kumar C., Fraczek S., Brin MF Botulinum toxin type a is a safe and effective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study.; Botox Detrusor Hyperreflexia Study Team. Spinal Cord Injury Centre, University Hospital Balgrist, Zurich, Switzerland.
• Del Popolo G1, Li Marzi V1, Panariello G1, Lombardi G1, Neuro-Urology, Florence ENGLISH BOTULINUM TOXIN-A IN THE TREATMENT OF NEUROGENIC DETRUSOR OVERACTIVITY. 2004.
• Hunskaar S., Burgio K. Epidemiology of Urinary and Faecal Incontinence and Pelvic Organ Prolapse. // In: Abrams P., Cardozo L., Khoury S., Incontinence. Paris, Health Publication. 2005. P. 255-312.
• Staskin DR, Te AE Short-and long-term efficacy of solifenacin treatment in patients with symptoms of mixed urinary incontinence. // BJU Int. 2006. Vol. 97. P. 1256-1261.
• Wein AJ Treatment of urge-predominant mixed urinary incontinence with tolterodine extended release: a randomized, placebo-controlled trial. // J. Urol. 2005. Vol. 173. P. 20562057.
• Bennett N., O'Leary M., Patel AS, Xavier M., Erickson JR, Chancellor MB Can higher doses of oxybutynin improve efficacy in neurogenic bladder? // J. Urol. 2004.Vol. 171. P. 749751.
• Abrams P., Cardozo L., Khoury S., Wein A. // In: Incontinence. 2nd International Consultation on Incontinence. Paris, Health Publications. 2001. P. 513.
• Schrepferman CG, Griebling TL, Nygaard IE, Kreder KJ Resolution of urge symptoms following sling cystourethropexy. //J. Urol. 2000. Vol. 164. P. 1628-1631.
• Patki PS, Hamid R., Arumugam K., Shah PJ, Craggs M. Botulinum toxin-type A in the treatment of drug-resistant neurogenic detrusor overactivity secondary to traumatic spinal cord injury. // BJU Int. 2006. Vol. 98. P. 77-82.
• Popat R., Apostolidis A., Kalsi V., Gonzales G., Fowler CJ, Dasgupta P. A comparison between the response of patients with idiopathic detrusor overactivity and neurogenic detrusor overactivity to the first intradetrusor injection of botulinum-A toxin. // J. Urol. 2005. Vol. 174. P. 984-989.
• Hamid R., Khastgir J., Arya M., Patel HR, Shah PJ Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders. // Spinal Cord. 2003. Vol. 41. P. 118-1121.
• Ranoux D., Gury C., Fondarai J., Mas JL, Zuber M. Respective potencies of Botox and Dysport: a double blind, randomized, crossover study in cervical dystonia. // J Neurol Neurosurg Psychiatry. 2002. Vol. 72. P. 459-462.
• Schurch B., de Seze M., Denys P., Chartier-Kastler E., Haab F., Everaert K. et al. Botulinum toxin type A is a safe and effective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study. // J. Urol. 2005. Vol. 174. P. 196-200.
• Sekhon LH, Fehlings MG Epidemiology, demographics, and pathophysiology of acute spinal cord injury. // Spine. 2001. Vol. 26, Suppl. 24. S. 2-12.
• Colombo M., Zanetta G., Vitobello D., Milani R. The Burch colposuspension for women with and without detrusor overactivity. //Br. J. Obstet. Gynaecol. 1996. Vol. 103. P. 255-260.
• Jeffry L., Deval B., Birsan A., Soriano D., Darai E. Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence. // Urology. 2001. Vol. 58. P. 702-706.
• Haferkamp A., Schurch B., Reitz A., Krengel U., Grosse J., Kramer G. et al. Lack of ultrastructural detrusor changes following endoscopic injection of botulinum toxin type a in overactive neurogenic bladder.// Eur. Urol. 2004. Vol. 46. ​​P. 784-791.
• Naumann M., So Y. et al. Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review). // Neurology. 2008. Vol. 70. P. 1707-1714.
• Artemenko A.R., Orlova O.R. Botox (botulism toxin type A) in the preventive treatment of migraine. // Collection of articles “Botox the power of experience.” M. 2005. P. 5-10.
• Krivoborodov G.G., Shkolnikov M.E. Treatment of functional disorders of bladder emptying. // Attending doctor. 2004. No. 9. P. 6-39.
• Lopatkin N.A., Ibragimov A.R., Mudraya I.S., Martov A.G., Salyukov R.V., Kirpatovsky V.I. Effect of botulinum toxin on bladder function. // Collection of materials from the XIV Russian National Congress “Man and Medicine”. M. 2007. P. 842.
• Mazo E.B., Krivoborodov G.G., Shkolnikov M.E., Efremov N.S. Use of botulinum toxin in urology. // Pharmateka. 2006. No. 10, P.125.
• Orlova O.R., Yakhno N.N. Use of Botox (botulism toxin type A) in clinical practice. M. 2001. 205 p.

Appendix No. 1

INFORMED CONSENT No. “_____” _______________ 20____

I,____________________________________________

is informed about the following circumstances of treatment with botulinum toxin type A Lantox:

1. the period of effective action of the drug is 4-6 months, after which repeated injection is possible;
2. the effect of the drug occurs 1-2 days after the procedure;
3. in the first 2-3 weeks after the injection, transient side effects may be observed: _______________________________________________________________________________
4. to prevent the formation of antibodies to the drug, the interval between repeated injections should exceed 8 weeks;
5. according to the International Movement Disorders Association, insensitivity to treatment is less than 0.01%;
6. Contraindications to injection are: acute cystitis, chronic prostatitis in the acute stage, myasthenia gravis, hemophilia, pregnancy, lactation, taking aminoglycoside antibiotics, tetracycline.

I am a doctor _______________________________________

informed the patient about the circumstances of the use of the drug Lantox.

I, ____________________________________________

I agree to be treated with Lantox. The required dose of the drug is ____________ UNITS. Signatures: Doctor ________________ ______________________________ _____________________________________________________ Patient _______________ Procedure protocol: _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ Signatures: Doctor ________________ ______________________________ _____________________________________________________ Patient _______________ Repeated examination “_____” ________________ 20__

Appendix No. 2

NOTE FOR PATIENTS

This leaflet is intended to inform you about the rules of behavior, side effects, and the timing of obtaining results after the procedure for administering the drug Lantox.

Rules for patient behavior after the procedure

1. Use uroantiseptics prescribed by your doctor for 5 days after the procedure.
2. Do not perform physical procedures, do not visit the bathhouse or sauna for 2 weeks after the procedure.
3. After 3 days, the patient must be examined by a doctor to determine the effectiveness of the procedure.

Deadline for receiving results

The effect of the drug Lantox occurs 1-2 days after the injection, the maximum effect is achieved after 1-4 weeks. The therapeutic period of drug administration is at least 6 months.

Possible side effects

1. Hematuria (blood in the urine). It usually goes away on its own within 2-3 days. Otherwise, consultation with a urologist is indicated.
2. Urinary retention, it is necessary to master the self-catheterization technique.
3. Allergic reactions to the components of the drug used during the procedure.
4. Formation of neutralizing antibodies to botulinum toxin after repeated procedures.

Appendix No. 3
ACT OF WRITTEN OFF

FULL NAME.
doctor who performed the procedure: _______________________ Date of the procedure: __________________________ Outpatient card numbers: __________________________ _____________________________________________________ Bottle series: _____________________________________ Expiration date: _____________________________________ Remaining units: _____________ amount: _________________ Justification: _____________________________________________________ _____________________________________________________ Signatures of the commission members: Head. department________________ (___________________) Senior nurse ________ (_______________) Attending physician _________________ (_____________) “___”_________________________ 20____ Appendix No. 4
Lantox drug accounting book form

Name of the product ________________________________________________________________________________ Units of measurement _________________________________________________________________________________

‹ Antibacterial prophylaxis in urology Up Prevention of nosocomial infection in dialysis departments ›

Description of the drug

Lantox is a protein-based product with a very high degree of purification. Botulinum neurotoxin type A is used as the main active substance. In addition, sucrose, dextran, and a stabilizer - gelatin (it is used for the manufacture of tablet shells and biological glue, which is used during surgical interventions) are added as auxiliary elements.

Note! It should be noted that a chemical reaction of gelatin with botulinum toxin does not occur, as a result of which the former does not enter the fibers of nerves and muscles.

In addition to botulinum toxin, Lantox contains other substances

This drug has a reduced price compared to analogues, has a fairly convenient release form, it is recommended to use it for treating small areas.

The advantages of the small container of the drug are not only convenience - any products with this active ingredient have an extremely limited shelf life (no longer than a day from the moment of dilution), and the use of expired drugs can cause unpleasant side effects. That is why it is best to administer only drugs that were diluted before the procedure.

The product must be prepared immediately before the procedure

Note! Medicines are stored at temperatures from -5 to +20 degrees.

Can the product be used in combination?

Before performing the procedure, you should always ask what medications you are currently taking.

And this is not easy. After all, their interaction with Lantox, and in particular with botulinum toxin, leads to serious consequences. Banned drugs include aminoglycoside antibiotics (for example, gentamicin). They are dangerous because they increase muscle paralysis.

Also, the following are not allowed for joint reception:

1. Medicines that have the same effect - muscle relaxant - because the effect is similar to the previous examples, intensify.
2. Antidepressants (also affect muscle condition).
3. Aspirin-based medications, when used together, can cause bruising, swelling, and bleeding.
4. Antipsychotics - due to the risk of damage to the nervous system (it is recommended to stop taking them a month before).

How does Lantox work?

As soon as the drug is injected under the skin, the muscle fibers in the affected area relax. The effectiveness of the product can be assessed after 48 hours, when the first visually noticeable positive effect occurs. After two weeks, it will be possible to observe the full effect of the drug. The duration of work is from six months, depending on favorable circumstances, this period can be longer, up to a year.

Note! Over time, the paralyzing effect on the muscles wears off and they gain the ability to contract again.

The initial effect will be noticeable after 48 hours

An additional positive effect of the product is that during the period of exposure, patients usually no longer need to squint or wrinkle their foreheads, due to which wrinkles arising from facial expressions are reduced, and there is a possibility of extending the duration of action for a long time.

The mechanism of action of Lantox is no different from the action of other drugs with the main substance in the form of botulinum toxin. It blocks a muscle (or a group of several muscles at once), smoothes the skin and relaxes muscle tissue.

Thanks to the “work” of the drug, the skin is smoothed

Once Lantox is administered, the following positive results can be experienced:

1. Elimination of wrinkles in the décolleté and neck area (injected into the thyroid cartilage).
2. Correction of the shape of lips and eyebrows (muscles are blocked, the corners of the mouth and eyebrows are raised).
3. Correction of hand skin, elimination of wrinkles.
4. Getting rid of excessive sweating (at the same time, Lantox does not eliminate the cause of hyperhidrosis, but only allows you to get rid of the symptom for a while).
5. Elimination of facial wrinkles in the areas:

• forehead (the drug is administered under the skin or directly into the muscle tissue approximately two centimeters above the eyebrows);
• in the area around the eyes (injection is carried out in the area of ​​the corner of the eye from the outside in the area of ​​the orbital border of the bone);
• nose (introduced along the sides of the nose and onto its back);
• mouth (the effect lasts a month, it is quite risky to use);
• chin.

Lantox allows you to smooth out wrinkles in different places

At a preliminary consultation with a cosmetologist, the problem areas into which Lantox will be injected are determined, and the dosage is selected taking into account the characteristics of the patient’s body. Usual dose: 100 units for removing wrinkles on the face, 200 units on the neck. A repeat session is usually carried out on average 2 months after the first.

What else is interesting to know when using Lantox?

At the moment, no addiction to the drug has been identified, but experts recommend not to “partialize” with the procedure. Recently, the “small dose” procedure has become popular, when the drug is administered in small doses. The “plus” of such a procedure is the reduction in cost and lively facial expressions, the “minus” is that the validity period is shorter, up to 4 months.

This is a rather controversial statement, but in other sources I was able to find the following: small doses of botulinum toxin over a short period of time can cause addiction and a complete lack of effect in the future.

I will also note that the drug has only a local effect on the muscle into which it is injected. Lantox has no general effect on the body.

The lethal dose of the drug for an adult has also been calculated - this is the administration of a dose equal to 30-40 units per kg. body weight.

Advantages and disadvantages of the drug Lantox

Before moving on to the specific features of this drug, let us note that many things are typical for most botulinum toxin-based products:

• possibility of allergic manifestations;
• the emergence of resistance (immunity due to addiction) to the toxin;
• reduced or absent effect.

This drug has some disadvantages

Let us separately note the last point - the low effectiveness of the drug is justified by the fact that antibodies to botulinum toxin arise in the body of some people (about 5% of the total number of patients) - usually this is due to a large amount of the previously administered drug.

Advantages of Lantox:

1. Extensive clinical studies . This remedy has been used for more than 20 years in various fields of medicine in many countries around the world.
2. High level of efficiency . Cosmetologists note that this drug usually acts for a longer time, up to 7-8 months.
3. Price . The cost of Lantox is almost two times less than other analogues of Russian or foreign production.
4. Safety . If the procedure is carried out with strict adherence to the standards of implementation, and the patient strictly adheres to the cosmetologist’s recommendations, then there are practically no side effects from Lantox.
5. Equipment . The drug is packaged in convenient small-capacity containers, which guarantees the use of only fresh, not expired solution.

Of course, Lantox has many advantages

Note! Thus, it can be noted that Lantox stands out favorably against the background of similar products.

Advantages and disadvantages

Advantages of the drug:

• Price. Among known analogues it has the lowest cost - 30-40% cheaper.
• The effect is noticeable by the end of the first day.
• High duration - 8-10 months.
• Availability of a convenient dosage of 50 units.
• The risk of adverse reactions is reduced due to minimal diffusion into nearby tissues.

Disadvantages of the drug : cases have been recorded when the body begins to produce antibodies to the active substance, which will subsequently neutralize the effect of rejuvenation.

Contraindications and special clarifications

Like any other neurotoxin, after using Lantox, unwanted side effects may occur, such as increasing swelling, slight pain after injections, muscle weakness, and sometimes an allergy to the drug. Other consequences include drooping of the eyelid (ptosis), the effect of stretched skin. Most of these problems go away after a few days (up to a week), others take a little longer.

Side effects, if they occur, disappear after a few days

In order to minimize possible risks, it is necessary to make sure that the patient does not have any contraindications to the sessions, and also to follow all recommendations and advice received from the doctor.

What should you do to recover faster after the procedure:

1. Cold compresses after injections will help reduce or completely eliminate swelling.
2. You must be in an upright position for about four hours after the session; it is not recommended to lower your head.
3. You cannot actively use the facial muscles (about three hours after the procedure).
4. Two weeks after the Lantox session, you need to refrain from massage, hot baths, saunas and solariums, avoid alcohol and take antibiotics.

Certain recommendations must be followed for successful rehabilitation after the procedure.

There are a number of contraindications in which Lantox is not used:

• period of pregnancy and breastfeeding;
• diseases associated with decreased blood clotting;
• taking medications such as antibiotics, anticoagulants, etc.;
• any diseases occurring in the acute stage;
• individual negative reaction of the body to the procedure;
• cancerous tumors;
• skin diseases, dermatitis, mechanical injuries to the skin in problem areas;
• epilepsy, mental diseases.

It is important to consider contraindications to the use of the drug

Carrying out manipulation - step-by-step instructions

The manipulation of the administration of any botulinum toxin must be carried out in a specialized medical center, in which all specialists performing this operation must be certified and have the appropriate permits to work with this drug:

1. Before the procedure, you must make sure that Lantox was stored at the required temperature: -5/-20 degrees.
2. The packaging must be intact, without traces of tampering.
3. The cosmetologist must collect all the basic information about the patient’s health status, whether there are any allergic reactions to protein or gelatin of animal origin. The doctor must also make sure that there are no neuralgic diseases, allergic risks, etc.
4. The doctor should then evaluate the condition of the skin at the injection site. It is unacceptable to inject botulinum toxins into areas with irritated skin, inflammatory formations, urticaria, etc.
5. Next, facial contractions are assessed and a correction plan is developed based on the client’s wishes and the doctor’s recommendations.
6. The skin is treated with an antiseptic, and the planned injection points are applied.
7. The doctor must provide maximum information about the product, inform the client about contraindications and side effects, and obtain written consent from the Client for the manipulation.
8. Next, local anesthesia is performed with an anesthetic gel.
9. The product is diluted only in the presence of the patient.
10. Injections are administered according to the developed plan for correction of the face or neck.

How does the procedure work?

The process of injecting Lantox occurs in the same way as with other botulinum toxin-based products. This procedure can only be performed by a specialist with the appropriate qualifications, a certified cosmetologist.

The fact is that failure to comply with the technique of administering drugs with Botox may result in the patient experiencing impaired facial expression or facial asymmetry.

It is important that the drug is administered correctly

The procedure begins with the cosmetologist examining the patient, collecting anamnesis and making sure that there are no contraindications to the procedure. The areas with the problem are identified and anesthesia is performed using a special cream.

Note! The total duration of the procedure is about half an hour, while the injections themselves take only a few minutes.

After the session, the doctor gives a list of recommendations that the patient must follow in order to avoid any negative consequences.

The doctor will consult the patient after the procedure

Alcohol compatibility

All alcoholic drinks contain ethanol.
It is quickly absorbed and enters the bloodstream. Acting on the walls of blood vessels, it reduces their tone, thereby promoting their expansion. As a result, blood flow and metabolic processes increase. And the interaction of botulinum toxin with alcohol will lead to the fact that it will quickly diffuse when it enters the body.

Consequences of compatibility with alcohol:

• small hematomas will appear at the injection site, and hemorrhage is also possible;
• swelling;
• weakening of injected muscle groups;
• the occurrence of symptoms of general intoxication and much more.

Other procedures combined with Lantox injections

Firstly, it should be noted that this can be contour plastic surgery, which is aimed at tightening tissues that are prone to sagging - it, unfortunately, does not eliminate fine expression wrinkles, so Lantox or another “Botox” drug works well with it goes well.

Laser rejuvenation. An excellent effect occurs when Lantox is combined with the technology of evaporating liquid from the upper skin. Typically the time between treatments is about two weeks.

Laser facial skin rejuvenation procedures can be carried out simultaneously

Note! A good effect is obtained by administering injections of hyaluronic acid (biorevitalization) - the substances used give the skin smoothness, and botulinum toxin fights expression wrinkles, and a very good result is obtained.

Lantox in cosmetology

Lantox is botulinum toxin type A, or it is commonly called botulinum toxin in the professional sphere, and is a complete analogue of Botox. Botulinum therapy in cosmetology is used for clearly formed facial wrinkles and increased sweating.

To smooth out wrinkles, botulinum toxin injections are administered:

• From above the brow ridges, retreat 2.5 mm, between the two insertion points there should be at least 20 mm.
• In the area of ​​“crow's feet” in the outer corner of the eye.
• Nose: two points on the back and on the side wings.
• There are two symmetrical injection sites on the chin.
• On the upper lip - it should be administered carefully so as not to disturb facial expressions.
• Neck - to increase elasticity.

For hyperhidrosis, that is, excessive sweating, the product is injected into the areas of the feet, palms or armpits.

Lantox and analogues

There are three main products most often used in Russia in the field of cosmetology, aimed at eliminating and preventing facial wrinkles. These are Botox, Dysport and Lantox itself.

The first drug, Botox, was developed in the USA at the end of the last century and was initially used to treat diseases such as strabismus and muscle spasms. Nowadays, it is widely used in aesthetic cosmetology, mainly to eliminate wrinkles and relieve symptoms of hyperhidrosis.

"Botox"

Based on Botox, the drug Dysport was subsequently developed, which had a lower cost and quickly gained popularity in most European countries.

"Dysport"

At the same time, research on botulinum toxin type A is being conducted in Chinese laboratories with the aim of introducing corresponding drugs on the Asian market. Lantox, obtained in this way, already had the necessary documents and certificates by 1997, and subsequently gained great popularity around the world.

Note! The laboratories that developed these products are completely independent of each other and are located in different parts of the planet, therefore, botulinum toxin of various strains was used. It follows from this that it is impossible to talk about the complete identity of these drugs; each of them is used for corresponding purposes, and they also differ in the degree of effectiveness and duration of influence.

Analogue drugs, although very similar, are not identical

As examples.

Botox is only used for patients under 50 years of age.

For hyperhidrosis, Dysport is most often used.

Lantox is usually used to prevent early wrinkles.

Information on the effectiveness of various drugs:

1. When using Botox, the final effect can be observed after two weeks to a month, its duration reaches six months.
2. Lantox makes it possible to evaluate the first positive effect just a day after the procedure, and after two weeks you can see the fully produced result. Duration – up to 11 months.
3. Dysport allows you to get an effect similar to previous drugs when using a threefold increase in dosage - for this reason, the drug is packaged larger.

The duration of the effect of Lantox is about 11 months

Another main difference between the funds is their cost. Botox is considered the most expensive in this category. On average, Lantox and Dysport cost approximately the same, their price is a third less than that of Botox, however, when using Dysport, approximately 4 times more substance is required to remove aesthetic imperfections.

Independent use

Is it possible to inject at home?

Independent use is strictly prohibited . And you cannot purchase it yourself, since it is sold only to specialized medical institutions.

Instructions for use

In most cases, Lantox is administered intramuscularly, but it can also be administered subcutaneously.

It is never used in its pure form - it is diluted by adding saline solution, hyaluronic acid or vitamins.

For hyperhidosis of the palms, feet or axillary area, Lantox is administered subcutaneously . And in order to smooth out wrinkles:

• Two subcutaneous or intramuscular injections are made in the forehead area at a distance of 2 centimeters from each other.
• One subcutaneous injection into the orbicularis oculi muscle.
• Two symmetrical injections are made into the nasal area.
• Intramuscularly into the chin area at two symmetrical points.
• Neck and décolleté area - injection into the area of ​​the thyroid cartilage.

Doses of the drug used

The generally accepted medical unit of measurement for botulinum toxin-based drugs is the unit of biological activity (action). Accordingly, for one unit of Botox and Lantox there are approximately 3x10 to the seventh power of molecules of the substance.

Note! Before carrying out the procedure, a general examination of the face by a cosmetologist is carried out, an anamnesis is collected, the condition of the muscle tissue is assessed, after which a decision is made on the required amount of the drug.

Before the procedure, the doctor examines the patient

How much medication is required on average:

1. To eliminate horizontal wrinkles on the forehead, 5 to 30 units of the drug are used. The distance between injections is about 20 mm.
2. For the eyebrow area and vertical wrinkles, you will need from 13 to 30 units.
3. Crow's feet around the eyes are eliminated by administering 10 to 20 units.
4. For the wings of the nose, injections are made according to symmetry, the amount is from 2 to 10 units.
5. More than 60 units are required for the neck.

A certain area requires a different number of units of the drug

The points at which the drug is injected are calculated individually for each patient, depending on differences in facial expressions and areas where wrinkles occur. In this case, the total total dosage when working with wrinkles in the face area should be no more than 100 units, and on the neck – 200 units. Excessive sweating is eliminated by administering from 6 to 200 units.

How are injections performed?

All drugs containing botulinum toxin are administered according to the same regimen . The procedure must be performed by a cosmetologist who has undergone appropriate training.

1. At the beginning, the doctor must examine the patient, collect a medical history, and find out whether the client is currently taking any medications.
2. Next, the specialist assesses the condition of the skin, conducts facial tests and selects the necessary correction scheme.
3. The cosmetologist must inform the client about the drug, its composition, contraindications, restrictions and the presence of adverse events.
4. Then informed consent is given for signature. And after signing it, they begin the procedure.

If the client wishes, the cosmetologist can administer anesthesia. The procedure takes from 10 to 30 minutes.

Recommendations after the procedure

Unfortunately, as with any cosmetic procedure, there is a risk of unwanted side effects. For example, some patients may experience excessive swelling, inflammation and pain in the area where the drug was administered.

Note! In patients prone to individual reactions, in some cases facial asymmetry, drooping eyelids, allergies or muscle weakness are recorded.

Sometimes side effects occur after the procedure, but this is rare

These are temporary effects, but in order to avoid them, it is strongly recommended to follow the advice of a cosmetologist, this will also help improve the result of the procedure:

1. After the session, it is recommended to use cold compresses to reduce the development of edema.
2. You should not lie down for about 3 hours; it is better to maintain an upright body position.
3. Massaging the areas where the neurotoxin is injected is prohibited.
4. All procedures associated with an increase in temperature (baths, saunas, solarium) are excluded.
5. Do not drink alcohol (for at least 10 days).
6. The facial muscles are not overstrained for about 4 hours after the session.
7. Do not take antibiotics (on average about two weeks).

You can't take antibiotics for a while

Most patients note that side effects practically do not develop after Lantex injections, however, some experience the following undesirable consequences:

• bruises and bruises in the place where the injection was made;
• painful and unpleasant sensations;
• the occurrence of an inflammatory process;
• headache;
• decreased sensitivity in the area of ​​the procedure;
• slight swelling;
• the occurrence of allergies;
• ptosis (drooping eyelid syndrome);
• flu-like symptoms;
• diplopia (visual double vision);
• facial asymmetry;
• feeling of skin tightness, “mask”;
• frequent spontaneous blinking;
• temporary difficulty swallowing and slurred speech.

The most common side effect is temporary headache

Rehabilitation process

The period after Lantox administration is important. And the duration of the effect and its manifestation, as well as the presence or absence of side effects, will depend on it.

Here are some recommendations to follow after “beauty injections”:

1. In the first 3-4 hours after injections, it is forbidden to take a horizontal position.
2. Do not rub the neurotoxin injection site.
3. Do not abuse alcohol.
4. It is recommended not to visit saunas, steam rooms, etc. for several weeks, as they, similar to the effects of alcohol-containing drinks, increase blood flow, which increases the area of ​​distribution of the drug.
5. It is prohibited to take antibiotics during the first 2 weeks.

Recommendations and reviews

Even though the drug has been used in Russia only recently, it has earned positive ratings from cosmetologists and other medical specialists. A large number of clinical studies have been conducted confirming the safety and effectiveness of Lantox.

As an example: when treating strabismus, the effect occurred in 76% of patients (this is much higher than when using standard methods of therapy, for example, surgical ones). For the treatment of spasms of the face and neck, the effectiveness reached 80%.

Doctors note the effectiveness of this remedy

A negative opinion widespread among experts points to the animal gelatin in the composition: it can cause an allergic reaction in some patients.

Reviews from cosmetologists

Anna , Mr. Volgograd, cosmetologist

“If you follow clear instructions for using Lantox, usually no problems arise. During the procedure, regulations are observed taking into account the individual characteristics of the patient. A muscle analysis is carried out and problem areas are noted. I have never encountered any problems when using Lantox; working with it is quite comfortable.”

Elena, Altai region, cosmetologist

“I consider Lantox a good remedy, in no way inferior to Botox. Unfortunately, many patients refuse to work with it, having learned that the drug is produced in China, they refuse to work with it, however, I consider this approach to be erroneous - none of the patients have yet had complaints about the procedure.”

Experts insist on a preliminary examination of the patient to avoid complications

Ksenia, Novosibirsk , plastic surgeon

“This drug is very popular in Asian countries; it has not yet received the same distribution in Russia. Personally, as a professional, I don’t see much significant difference in the drugs. The effect and working features are the same as Botox; clients often use it due to the reduced price. The effect is the same, we hardly encounter any complications.”

Patient reviews

There are varied opinions from those who have used Lantox, both positive and negative.

Most clients of beauty salons who have undergone the procedure leave generally positive reviews, note the speed at which the first wrinkles are eliminated in a few days, and are satisfied with the long-lasting effect of the product (usually about 8 months).

Also, many positive reviews come from those who are satisfied with the low price and long-lasting effect.

Negative reviews also exist, but are usually justified either by side effects of the drug or by normal conditions associated with discomfort after the procedure (unfortunately, slight asymmetry, swelling, and pain may occur). Most often, no trace of such effects remains after just a few days.

There are not many negative reviews about Lantox

Another part of the negative reviews is due to the fact that clients had to deal with unqualified employees of cosmetology clinics and an unprofessional approach to the procedure - to avoid this, it is recommended to approach the selection of specialists with great responsibility, and do not hesitate to ask for the appropriate certificates and licenses.

Valentina , Arkhangelsk

“I injected Botox for the first time after 35 years, I really liked the effect - the skin looks fresh, wrinkles go away. The effect was long-lasting, up to 9 months. After some time, I replaced the drug with Lantox - the result was similar to Botox, but after the procedure I felt a slight tension in the muscles.”

People like this drug

Julia, Saratov

“With the help of Lantox I got rid of hyperhidrosis. The choice fell on this drug because of its low cost and safety. I am satisfied with the effect, it lasted about 8 months. This became a real salvation in the summer!”

What should you not do after injections?

Cosmetologists warn that the effect of the drug depends on the body’s metabolism. Therefore, some procedures that speed up metabolism may slightly shorten the duration of the drug. This is, for example, active fitness classes, visiting a bathhouse or sauna.

It is difficult to verify this fact, because it is necessary to at least conduct a comparative experiment on one person so that the initial data are approximately the same. Let’s just take these expert reviews into account; it’s hardly worth giving up a healthy lifestyle in favor of an extra week of Lantox. But it is better to refrain from visiting bathhouses and active sports for the first days after the procedure.

It is also not recommended to expose the skin to ultraviolet radiation and sudden temperature changes during the first weeks after the injection. That is, refrain from visiting the solarium, sunbathing, and walking in the cold. Quite tolerable recommendations.

Photos before and after

Photos before and after using Lantox No. 1

Photos before and after using Lantox No. 2

Photos before and after using Lantox No. 3