Drug guidance
Botulinum toxin A for treating focal spasticity of the upper or lower limbs in children with cerebral palsy
Condition
Musculoskeletal
16 September 2025
Published on 02 Sep 2019
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 treating children, aged 2 years or older, with focal spasticity of the upper or lower limbs (including dynamic equinus foot deformity) due to cerebral palsy, and who:
do not have significant joint contractures, i.e. the affected joint is not permanently fixed in position due to shortening of the target muscle; and
are concurrently receiving ongoing supportive therapy, e.g. physiotherapy or occupational therapy.
Botulinum toxin type A must be administered by a physician specialising in paediatric neurological disorders or paediatric rehabilitation with experience in administering botulinum toxin type 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 2 September 2019.
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.