IMPORTANT SAFETY INFORMATION FOR JEUVEAU® (prabotulinumtoxinA-xvfs)

WARNING: DISTANT SPREAD OF TOXIN EFFECT: The effects of all botulinum toxin products, including JEUVEAU, may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines.

CONTRAINDICATIONS

JEUVEAU is contraindicated in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation, and in the presence of infection at the proposed injection site(s).

WARNINGS AND PRECAUTIONS

Spread of Toxin Effect

Postmarketing safety data from other approved botulinum toxins suggest that botulinum toxin effects may be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of botulinum toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, blurred vision and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death related to spread of toxin effects. In unapproved uses, including upper limb spasticity in children and approved indications, symptoms consistent with spread of toxin effect have been reported at doses comparable to or lower than the maximum recommended total dose. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory difficulties occur.

Lack of Interchangeability between Botulinum Toxin Products

The potency Units of JEUVEAU are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of JEUVEAU cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Serious Adverse Reactions with Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received botulinum toxin injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of botulinum toxin products to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of botulinum toxin products.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported for botulinum toxin products, including anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur with JEUVEAU, discontinue use of JEUVEAU and immediately institute appropriate medical therapy.

Cardiovascular System

There have been reports following administration of botulinum toxins of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects with Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) were excluded from the JEUVEAU clinical studies. Patients with neuromuscular disorders may be at increased risk of clinically significant effects, including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise from typical doses of JEUVEAU.

Dysphagia and Breathing Difficulties

Treatment with botulinum toxin products, including JEUVEAU, can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing. (See Boxed Warning for Spread of Toxin Effect)

Pre-existing Conditions at the Injection Site

Caution should be used when JEUVEAU is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s). Caution should be used when JEUVEAU treatment is used in patients who have marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin or when subjects do not respond to 20 Units of botulinum toxin (e.g. the inability to substantially lessen glabellar lines even by physically spreading them apart). Do not exceed the recommended dosage and frequency of administration of JEUVEAU.

Ophthalmic Adverse Reactions in Patients Treated with Botulinum Toxin Products

Dry eye has been reported with the use of botulinum toxin products in the treatment of glabellar lines. Reduced tear production, reduced blinking, and corneal disorders, may occur with use of botulinum toxins, including JEUVEAU. If symptoms of dry eye (e.g., eye irritation, photophobia, or visual changes) persist, consider referring patient to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

JEUVEAU contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) is also considered extremely remote. No cases of transmission of viral diseases or CJD have ever been reported for albumin.

ADVERSE REACTIONS

The most frequently reported adverse reactions (≥ 1% and placebo) following injection of JEUVEAU were headache (12%), eyelid ptosis (2%), upper respiratory tract infection (3%), and white blood cell count increase (1%).

DRUG INTERACTIONS

No formal drug interaction studies have been conducted with JEUVEAU. The potential for certain drugs to potentiate the effects of JEUVEAU warrant consideration given the potential risks involved and should be used with caution, including: aminoglycosides or other agents interfering with neuromuscular transmission, anticholinergic drugs, botulinum neurotoxin products, and muscle relaxants.

USE IN SPECIFIC POPULATIONS

The limited available data on JEUVEAU use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes.

There are no data on the presence of JEUVEAU in human or animal milk, its effects on the breastfed infant, or its effects on milk production.

Safety and effectiveness in pediatric patients have not been established.

INDICATION

JEUVEAU is an acetylcholine release inhibitor and a neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.

Please note that this information is not comprehensive. For more information about JEUVEAU, see the full Prescribing Information including BOXED WARNING, and Medication Guide, or visit evolusrx.com

To report side effects associated with use of JEUVEAU, please call 1-877-EVOLUS1 (1-877-386-5871). You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Exclusively licensed and manufactured for: Evolus, Inc., 520 Newport Center Drive, Suite 1200, Newport Beach, CA 92660 ©2025 Evolus, Inc. All rights reserved. All trademarks are the property of their respective owners.

References

1. Jeuveau® [package insert]. Evolus, Inc; 2023.
2. Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov (NY). Epub 2012.
3. Kim CS, Song KY, Min KM, An YD, inventors; Daewoong Co, Ltd, assignee. Method for production of botulinum toxin. US patent 9,512,418 B2. December 6, 2016.
4. Kaminer MS, Cox SE, Fagien S, Kaufman J, Lupo M, Shamban A. Re-examining the optimal use of neuromodulators and the changing landscape: A consensus panel update. J Drugs Dermatol. 2020;19(4 suppl 1):s5-15.
5. Rzany BJ, Ascher B, Avelar RL, et al. A multicenter, randomized, double-blind, placebo-controlled, single-dose, phase 3, non-inferiority study comparing prabotulinumtoxinA and onabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients. Aesthet Surg J. 2020;40(4):413-429.
6. Data on file; REF-00258. Evolus, Inc., Newport Beach, CA.
7. Beer KR, Shamban AT, Avelar RL, Gross JE, Jonker A. Efficacy and safety of prabotulinumtoxinA for the treatment of glabellar lines in adult subjects: results from 2 identical phase 3 studies. Dermatol Surg. 2019;45(11):1381-1393.
8. Data on file; REF-00346, Evolus, Inc, Newport Beach, CA.
9. Data on file; REF-00347, Evolus, Inc, Newport Beach, CA.
10. Data on file; REF-00257, Evolus, Inc., Newport Beach, CA.
11. Kaufman-Janette J, Avelar RL, Biesman BS, et al. The first of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients[published correction appears in Aesthet Sur J. 2021 Nov 12;41(12):1494. doi: 10.1093/asj/sjab229]. Aesthet Surg J. 2021;41(12):1409-1422.
12. Lorenc ZP, Adelglass JM, Avelar RL, et al. The second of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients [published correction appears in Aesthet Surg J. 2021 Nov 12;41(12):1494-1495. doi: 10.1093/asj/sjab230]. Aesthet Surg J. 2021;41(12):1423-1438.
13. Solish N, Ascher B, Avelar RL, et al. PrabotulinumtoxinA vs onabotulinumtoxinA for the treatment of adult males with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Aesthet Surg J. 2022;42(12):1460-1469.
14. Ogilvie P, Jones DH, Avelar RL, Jonker A, Monroe R, Carruthers J. PrabotulinumtoxinA for treatment of millennials with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Dermatol Surg. 2022;48(6):664-669.
15. American Society of Plastic Surgeons. 2022 Plastic Surgery Statistics Report, www.plasticsurgery.org/documents/news/Statistics/2022/plastic- surgery-statistics-report- 2022.pdf. Accessed 6 June 2024.
16. Evolus® AAU Millennial Market Research 2018. Evolus, Inc., Newport Beach, CA.
17. Avelar, Rui MD. Botulinum Toxin Accessory Proteins: Are They Just an Accessory?. Dermatologic Surgery 50(9S):p S38-S41, September 2024.

US-JUV-2400451V2

IMPORTANT SAFETY INFORMATION FOR JEUVEAU® (prabotulinumtoxinA-xvfs)

WARNING: DISTANT SPREAD OF TOXIN EFFECT: The effects of all botulinum toxin products, including JEUVEAU, may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines.

CONTRAINDICATIONS

JEUVEAU is contraindicated in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation, and in the presence of infection at the proposed injection site(s).

WARNINGS AND PRECAUTIONS

Spread of Toxin Effect

Postmarketing safety data from other approved botulinum toxins suggest that botulinum toxin effects may be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of botulinum toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, blurred vision and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death related to spread of toxin effects. In unapproved uses, including upper limb spasticity in children and approved indications, symptoms consistent with spread of toxin effect have been reported at doses comparable to or lower than the maximum recommended total dose. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory difficulties occur.

Lack of Interchangeability between Botulinum Toxin Products

The potency Units of JEUVEAU are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of JEUVEAU cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Serious Adverse Reactions with Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received botulinum toxin injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of botulinum toxin products to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of botulinum toxin products.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported for botulinum toxin products, including anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur with JEUVEAU, discontinue use of JEUVEAU and immediately institute appropriate medical therapy.

Cardiovascular System

There have been reports following administration of botulinum toxins of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects with Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) were excluded from the JEUVEAU clinical studies. Patients with neuromuscular disorders may be at increased risk of clinically significant effects, including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise from typical doses of JEUVEAU.

Dysphagia and Breathing Difficulties

Treatment with botulinum toxin products, including JEUVEAU, can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing. (See Boxed Warning for Spread of Toxin Effect)

Pre-existing Conditions at the Injection Site

Caution should be used when JEUVEAU is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s). Caution should be used when JEUVEAU treatment is used in patients who have marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin or when subjects do not respond to 20 Units of botulinum toxin (e.g. the inability to substantially lessen glabellar lines even by physically spreading them apart). Do not exceed the recommended dosage and frequency of administration of JEUVEAU.

Ophthalmic Adverse Reactions in Patients Treated with Botulinum Toxin Products

Dry eye has been reported with the use of botulinum toxin products in the treatment of glabellar lines. Reduced tear production, reduced blinking, and corneal disorders, may occur with use of botulinum toxins, including JEUVEAU. If symptoms of dry eye (e.g., eye irritation, photophobia, or visual changes) persist, consider referring patient to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

JEUVEAU contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) is also considered extremely remote. No cases of transmission of viral diseases or CJD have ever been reported for albumin.

ADVERSE REACTIONS

The most frequently reported adverse reactions (≥ 1% and placebo) following injection of JEUVEAU were headache (12%), eyelid ptosis (2%), upper respiratory tract infection (3%), and white blood cell count increase (1%).

DRUG INTERACTIONS

No formal drug interaction studies have been conducted with JEUVEAU. The potential for certain drugs to potentiate the effects of JEUVEAU warrant consideration given the potential risks involved and should be used with caution, including: aminoglycosides or other agents interfering with neuromuscular transmission, anticholinergic drugs, botulinum neurotoxin products, and muscle relaxants.

USE IN SPECIFIC POPULATIONS

The limited available data on JEUVEAU use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes.

There are no data on the presence of JEUVEAU in human or animal milk, its effects on the breastfed infant, or its effects on milk production.

Safety and effectiveness in pediatric patients have not been established.

INDICATION

JEUVEAU is an acetylcholine release inhibitor and a neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.

Please note that this information is not comprehensive. For more information about JEUVEAU, see the full Prescribing Information including BOXED WARNING, and Medication Guide, or visit evolusrx.com

To report side effects associated with use of JEUVEAU, please call 1-877-EVOLUS1 (1-877-386-5871). You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Exclusively licensed and manufactured for: Evolus, Inc., 520 Newport Center Drive, Suite 1200, Newport Beach, CA 92660 ©2025 Evolus, Inc. All rights reserved. All trademarks are the property of their respective owners.

References

1. Jeuveau® [package insert]. Evolus, Inc; 2023.
2. Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov (NY). Epub 2012.
3. Kim CS, Song KY, Min KM, An YD, inventors; Daewoong Co, Ltd, assignee. Method for production of botulinum toxin. US patent 9,512,418 B2. December 6, 2016.
4. Kaminer MS, Cox SE, Fagien S, Kaufman J, Lupo M, Shamban A. Re-examining the optimal use of neuromodulators and the changing landscape: A consensus panel update. J Drugs Dermatol. 2020;19(4 suppl 1):s5-15.
5. Rzany BJ, Ascher B, Avelar RL, et al. A multicenter, randomized, double-blind, placebo-controlled, single-dose, phase 3, non-inferiority study comparing prabotulinumtoxinA and onabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients. Aesthet Surg J. 2020;40(4):413-429.
6. Data on file; REF-00258. Evolus, Inc., Newport Beach, CA.
7. Beer KR, Shamban AT, Avelar RL, Gross JE, Jonker A. Efficacy and safety of prabotulinumtoxinA for the treatment of glabellar lines in adult subjects: results from 2 identical phase 3 studies. Dermatol Surg. 2019;45(11):1381-1393.
8. Data on file; REF-00346, Evolus, Inc, Newport Beach, CA.
9. Data on file; REF-00347, Evolus, Inc, Newport Beach, CA.
10. Data on file; REF-00257, Evolus, Inc., Newport Beach, CA.
11. Kaufman-Janette J, Avelar RL, Biesman BS, et al. The first of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients[published correction appears in Aesthet Sur J. 2021 Nov 12;41(12):1494. doi: 10.1093/asj/sjab229]. Aesthet Surg J. 2021;41(12):1409-1422.
12. Lorenc ZP, Adelglass JM, Avelar RL, et al. The second of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients [published correction appears in Aesthet Surg J. 2021 Nov 12;41(12):1494-1495. doi: 10.1093/asj/sjab230]. Aesthet Surg J. 2021;41(12):1423-1438.
13. Solish N, Ascher B, Avelar RL, et al. PrabotulinumtoxinA vs onabotulinumtoxinA for the treatment of adult males with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Aesthet Surg J. 2022;42(12):1460-1469.
14. Ogilvie P, Jones DH, Avelar RL, Jonker A, Monroe R, Carruthers J. PrabotulinumtoxinA for treatment of millennials with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Dermatol Surg. 2022;48(6):664-669.
15. American Society of Plastic Surgeons. 2022 Plastic Surgery Statistics Report, www.plasticsurgery.org/documents/news/Statistics/2022/plastic- surgery-statistics-report- 2022.pdf. Accessed 6 June 2024.
16. Evolus® AAU Millennial Market Research 2018. Evolus, Inc., Newport Beach, CA.
17. Avelar, Rui MD. Botulinum Toxin Accessory Proteins: Are They Just an Accessory?. Dermatologic Surgery 50(9S):p S38-S41, September 2024.

US-JUV-2400451V2

IMPORTANT SAFETY INFORMATION FOR JEUVEAU® (prabotulinumtoxinA-xvfs)

WARNING: DISTANT SPREAD OF TOXIN EFFECT: The effects of all botulinum toxin products, including JEUVEAU, may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines.

CONTRAINDICATIONS

JEUVEAU is contraindicated in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation, and in the presence of infection at the proposed injection site(s).

WARNINGS AND PRECAUTIONS

Spread of Toxin Effect

Postmarketing safety data from other approved botulinum toxins suggest that botulinum toxin effects may be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of botulinum toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, blurred vision and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death related to spread of toxin effects. In unapproved uses, including upper limb spasticity in children and approved indications, symptoms consistent with spread of toxin effect have been reported at doses comparable to or lower than the maximum recommended total dose. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory difficulties occur.

Lack of Interchangeability between Botulinum Toxin Products

The potency Units of JEUVEAU are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of JEUVEAU cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Serious Adverse Reactions with Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received botulinum toxin injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of botulinum toxin products to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of botulinum toxin products.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported for botulinum toxin products, including anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur with JEUVEAU, discontinue use of JEUVEAU and immediately institute appropriate medical therapy.

Cardiovascular System

There have been reports following administration of botulinum toxins of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects with Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) were excluded from the JEUVEAU clinical studies. Patients with neuromuscular disorders may be at increased risk of clinically significant effects, including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise from typical doses of JEUVEAU.

Dysphagia and Breathing Difficulties

Treatment with botulinum toxin products, including JEUVEAU, can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing. (See Boxed Warning for Spread of Toxin Effect)

Pre-existing Conditions at the Injection Site

Caution should be used when JEUVEAU is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s). Caution should be used when JEUVEAU treatment is used in patients who have marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin or when subjects do not respond to 20 Units of botulinum toxin (e.g. the inability to substantially lessen glabellar lines even by physically spreading them apart). Do not exceed the recommended dosage and frequency of administration of JEUVEAU.

Ophthalmic Adverse Reactions in Patients Treated with Botulinum Toxin Products

Dry eye has been reported with the use of botulinum toxin products in the treatment of glabellar lines. Reduced tear production, reduced blinking, and corneal disorders, may occur with use of botulinum toxins, including JEUVEAU. If symptoms of dry eye (e.g., eye irritation, photophobia, or visual changes) persist, consider referring patient to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

JEUVEAU contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) is also considered extremely remote. No cases of transmission of viral diseases or CJD have ever been reported for albumin.

ADVERSE REACTIONS

The most frequently reported adverse reactions (≥ 1% and placebo) following injection of JEUVEAU were headache (12%), eyelid ptosis (2%), upper respiratory tract infection (3%), and white blood cell count increase (1%).

DRUG INTERACTIONS

No formal drug interaction studies have been conducted with JEUVEAU. The potential for certain drugs to potentiate the effects of JEUVEAU warrant consideration given the potential risks involved and should be used with caution, including: aminoglycosides or other agents interfering with neuromuscular transmission, anticholinergic drugs, botulinum neurotoxin products, and muscle relaxants.

USE IN SPECIFIC POPULATIONS

The limited available data on JEUVEAU use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes.

There are no data on the presence of JEUVEAU in human or animal milk, its effects on the breastfed infant, or its effects on milk production.

Safety and effectiveness in pediatric patients have not been established.

INDICATION

JEUVEAU is an acetylcholine release inhibitor and a neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.

Please note that this information is not comprehensive. For more information about JEUVEAU, see the full Prescribing Information including BOXED WARNING, and Medication Guide, or visit evolusrx.com

To report side effects associated with use of JEUVEAU, please call 1-877-EVOLUS1 (1-877-386-5871). You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Exclusively licensed and manufactured for: Evolus, Inc., 520 Newport Center Drive, Suite 1200, Newport Beach, CA 92660 ©2025 Evolus, Inc. All rights reserved. All trademarks are the property of their respective owners.

References

1. Jeuveau® [package insert]. Evolus, Inc; 2023.
2. Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov (NY). Epub 2012.
3. Kim CS, Song KY, Min KM, An YD, inventors; Daewoong Co, Ltd, assignee. Method for production of botulinum toxin. US patent 9,512,418 B2. December 6, 2016.
4. Kaminer MS, Cox SE, Fagien S, Kaufman J, Lupo M, Shamban A. Re-examining the optimal use of neuromodulators and the changing landscape: A consensus panel update. J Drugs Dermatol. 2020;19(4 suppl 1):s5-15.
5. Rzany BJ, Ascher B, Avelar RL, et al. A multicenter, randomized, double-blind, placebo-controlled, single-dose, phase 3, non-inferiority study comparing prabotulinumtoxinA and onabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients. Aesthet Surg J. 2020;40(4):413-429.
6. Data on file; REF-00258. Evolus, Inc., Newport Beach, CA.
7. Beer KR, Shamban AT, Avelar RL, Gross JE, Jonker A. Efficacy and safety of prabotulinumtoxinA for the treatment of glabellar lines in adult subjects: results from 2 identical phase 3 studies. Dermatol Surg. 2019;45(11):1381-1393.
8. Data on file; REF-00346, Evolus, Inc, Newport Beach, CA.
9. Data on file; REF-00347, Evolus, Inc, Newport Beach, CA.
10. Data on file; REF-00257, Evolus, Inc., Newport Beach, CA.
11. Kaufman-Janette J, Avelar RL, Biesman BS, et al. The first of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients[published correction appears in Aesthet Sur J. 2021 Nov 12;41(12):1494. doi: 10.1093/asj/sjab229]. Aesthet Surg J. 2021;41(12):1409-1422.
12. Lorenc ZP, Adelglass JM, Avelar RL, et al. The second of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients [published correction appears in Aesthet Surg J. 2021 Nov 12;41(12):1494-1495. doi: 10.1093/asj/sjab230]. Aesthet Surg J. 2021;41(12):1423-1438.
13. Solish N, Ascher B, Avelar RL, et al. PrabotulinumtoxinA vs onabotulinumtoxinA for the treatment of adult males with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Aesthet Surg J. 2022;42(12):1460-1469.
14. Ogilvie P, Jones DH, Avelar RL, Jonker A, Monroe R, Carruthers J. PrabotulinumtoxinA for treatment of millennials with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Dermatol Surg. 2022;48(6):664-669.
15. American Society of Plastic Surgeons. 2022 Plastic Surgery Statistics Report, www.plasticsurgery.org/documents/news/Statistics/2022/plastic- surgery-statistics-report- 2022.pdf. Accessed 6 June 2024.
16. Evolus® AAU Millennial Market Research 2018. Evolus, Inc., Newport Beach, CA.
17. Avelar, Rui MD. Botulinum Toxin Accessory Proteins: Are They Just an Accessory?. Dermatologic Surgery 50(9S):p S38-S41, September 2024.

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IMPORTANT SAFETY INFORMATION FOR JEUVEAU® (prabotulinumtoxinA-xvfs)

WARNING: DISTANT SPREAD OF TOXIN EFFECT: The effects of all botulinum toxin products, including JEUVEAU, may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines.

CONTRAINDICATIONS

JEUVEAU is contraindicated in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation, and in the presence of infection at the proposed injection site(s).

WARNINGS AND PRECAUTIONS

Spread of Toxin Effect

Postmarketing safety data from other approved botulinum toxins suggest that botulinum toxin effects may be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of botulinum toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, blurred vision and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death related to spread of toxin effects. In unapproved uses, including upper limb spasticity in children and approved indications, symptoms consistent with spread of toxin effect have been reported at doses comparable to or lower than the maximum recommended total dose. JEUVEAU is not approved for the treatment of spasticity or any conditions other than glabellar lines. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory difficulties occur.

Lack of Interchangeability between Botulinum Toxin Products

The potency Units of JEUVEAU are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of JEUVEAU cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Serious Adverse Reactions with Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received botulinum toxin injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of botulinum toxin products to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of botulinum toxin products.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported for botulinum toxin products, including anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur with JEUVEAU, discontinue use of JEUVEAU and immediately institute appropriate medical therapy.

Cardiovascular System

There have been reports following administration of botulinum toxins of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects with Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) were excluded from the JEUVEAU clinical studies. Patients with neuromuscular disorders may be at increased risk of clinically significant effects, including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise from typical doses of JEUVEAU.

Dysphagia and Breathing Difficulties

Treatment with botulinum toxin products, including JEUVEAU, can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing. (See Boxed Warning for Spread of Toxin Effect)

Pre-existing Conditions at the Injection Site

Caution should be used when JEUVEAU is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s). Caution should be used when JEUVEAU treatment is used in patients who have marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin or when subjects do not respond to 20 Units of botulinum toxin (e.g. the inability to substantially lessen glabellar lines even by physically spreading them apart). Do not exceed the recommended dosage and frequency of administration of JEUVEAU.

Ophthalmic Adverse Reactions in Patients Treated with Botulinum Toxin Products

Dry eye has been reported with the use of botulinum toxin products in the treatment of glabellar lines. Reduced tear production, reduced blinking, and corneal disorders, may occur with use of botulinum toxins, including JEUVEAU. If symptoms of dry eye (e.g., eye irritation, photophobia, or visual changes) persist, consider referring patient to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

JEUVEAU contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) is also considered extremely remote. No cases of transmission of viral diseases or CJD have ever been reported for albumin.

ADVERSE REACTIONS

The most frequently reported adverse reactions (≥ 1% and placebo) following injection of JEUVEAU were headache (12%), eyelid ptosis (2%), upper respiratory tract infection (3%), and white blood cell count increase (1%).

DRUG INTERACTIONS

No formal drug interaction studies have been conducted with JEUVEAU. The potential for certain drugs to potentiate the effects of JEUVEAU warrant consideration given the potential risks involved and should be used with caution, including: aminoglycosides or other agents interfering with neuromuscular transmission, anticholinergic drugs, botulinum neurotoxin products, and muscle relaxants.

USE IN SPECIFIC POPULATIONS

The limited available data on JEUVEAU use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes.

There are no data on the presence of JEUVEAU in human or animal milk, its effects on the breastfed infant, or its effects on milk production.

Safety and effectiveness in pediatric patients have not been established.

INDICATION

JEUVEAU is an acetylcholine release inhibitor and a neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.

Please note that this information is not comprehensive. For more information about JEUVEAU, see the full Prescribing Information including BOXED WARNING, and Medication Guide, or visit evolusrx.com

To report side effects associated with use of JEUVEAU, please call 1-877-EVOLUS1 (1-877-386-5871). You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Exclusively licensed and manufactured for: Evolus, Inc., 520 Newport Center Drive, Suite 1200, Newport Beach, CA 92660 ©2025 Evolus, Inc. All rights reserved. All trademarks are the property of their respective owners.

References

1. Jeuveau® [package insert]. Evolus, Inc; 2023.
2. Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov (NY). Epub 2012.
3. Kim CS, Song KY, Min KM, An YD, inventors; Daewoong Co, Ltd, assignee. Method for production of botulinum toxin. US patent 9,512,418 B2. December 6, 2016.
4. Kaminer MS, Cox SE, Fagien S, Kaufman J, Lupo M, Shamban A. Re-examining the optimal use of neuromodulators and the changing landscape: A consensus panel update. J Drugs Dermatol. 2020;19(4 suppl 1):s5-15.
5. Rzany BJ, Ascher B, Avelar RL, et al. A multicenter, randomized, double-blind, placebo-controlled, single-dose, phase 3, non-inferiority study comparing prabotulinumtoxinA and onabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients. Aesthet Surg J. 2020;40(4):413-429.
6. Data on file; REF-00258. Evolus, Inc., Newport Beach, CA.
7. Beer KR, Shamban AT, Avelar RL, Gross JE, Jonker A. Efficacy and safety of prabotulinumtoxinA for the treatment of glabellar lines in adult subjects: results from 2 identical phase 3 studies. Dermatol Surg. 2019;45(11):1381-1393.
8. Data on file; REF-00346, Evolus, Inc, Newport Beach, CA.
9. Data on file; REF-00347, Evolus, Inc, Newport Beach, CA.
10. Data on file; REF-00257, Evolus, Inc., Newport Beach, CA.
11. Kaufman-Janette J, Avelar RL, Biesman BS, et al. The first of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients[published correction appears in Aesthet Sur J. 2021 Nov 12;41(12):1494. doi: 10.1093/asj/sjab229]. Aesthet Surg J. 2021;41(12):1409-1422.
12. Lorenc ZP, Adelglass JM, Avelar RL, et al. The second of two one-year, multicenter, open-label, repeat-dose, phase II safety studies of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients [published correction appears in Aesthet Surg J. 2021 Nov 12;41(12):1494-1495. doi: 10.1093/asj/sjab230]. Aesthet Surg J. 2021;41(12):1423-1438.
13. Solish N, Ascher B, Avelar RL, et al. PrabotulinumtoxinA vs onabotulinumtoxinA for the treatment of adult males with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Aesthet Surg J. 2022;42(12):1460-1469.
14. Ogilvie P, Jones DH, Avelar RL, Jonker A, Monroe R, Carruthers J. PrabotulinumtoxinA for treatment of millennials with moderate to severe glabellar lines: post-hoc analyses of the phase 3 clinical study data. Dermatol Surg. 2022;48(6):664-669.
15. American Society of Plastic Surgeons. 2022 Plastic Surgery Statistics Report, www.plasticsurgery.org/documents/news/Statistics/2022/plastic- surgery-statistics-report- 2022.pdf. Accessed 6 June 2024.
16. Evolus® AAU Millennial Market Research 2018. Evolus, Inc., Newport Beach, CA.
17. Avelar, Rui MD. Botulinum Toxin Accessory Proteins: Are They Just an Accessory?. Dermatologic Surgery 50(9S):p S38-S41, September 2024.

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