Botulinum toxin A for the management of focal spasticity of the lower limbs associated with stroke in adults

Published on 01 Jun 2023
Last Updated on 16 Sep 2025

Guidance Recommendations

The Ministry of Health's Drug Advisory Committee has recommended:

• Clostridium botulinum toxin type A neurotoxin complex (Botox) 50 U and 100 U injection vials, and

• Clostridium botulinum type A toxin-haemagglutinin complex (Dysport) 300 U and 500 U injection vials

for the management of focal spasticity of the lower limbs associated with stroke in adults who:

• have a score of 3 or more on the Modified Ashworth Scale at the target muscle intended for botulinum toxin A treatment;

• do not have the affected joint permanently fixed in position due to fibrotic shortening of the target muscle; and

• are concurrently receiving physiotherapy.

Botulinum toxin A must be administered by either a neurologist trained in movement disorder or a rehabilitation physician who has undergone training to administer botulinum toxin A.

Funding status

Clostridium botulinum toxin type A neurotoxin complex (Botox) 50 U and 100 U injection vials are recommended for inclusion on the Medication Assistance Fund (MAF) for the abovementioned indication from 1 August 2023.

Clostridium botulinum type A toxin-haemagglutinin complex (Dysport) 300 U and 500 U injection vials are recommended for inclusion on the MAF for the abovementioned indication from 1 November 2025.

MAF assistance does not apply to Botox 200 U injection vial or other brands of botulinum toxin A.

Botulinum toxin A for the management of focal spasticity of the lower limbs associated with stroke in adults (Updated 16 Sep 2025) [PDF, 132 KB]

PES Botulinum toxin A for treating adults with focal spasticity of the lower limbs associated with stroke (Updated 16 Sep 2025) [PDF, 71 KB]