A JAMA editorial discusses recent changes to the terminology of botulinum toxins in the US.

There are now four different injectable botulinum toxin preparations available in the US, three type A and one type B (compared to 7 in the UK – 6 type A and 1 type B), and the FDA has mandated the use of specific non-proprietary (generic) names for each of the different variants. The author of the editorial discusses the reasoning behind the use of these generic names (which he notes are ‘almost unpronounceable’), commenting that the various products are different in manufacturing, potency, and dosing. As a result, they have potentially significant differences in efficacy, safety profile, and antigenic potential, and require expertise to swap from one to another. He discusses the potential problems posed by the availability of a range of botulinum preparations, and welcomes the new terminology in the hope that it will reduce errors and misinterpretation, and should be of benefit for patients.