In their announcing new labelling information for the drugs, Health Canada said that the toxin in Botox products may spread to distant parts of the body, with potentially fatal consequences.

It was FDA that has reported that the toxin had spread, both in products the agency approved and those that were not and Health Canada has decided to review the safety of Botox and Botox Cosmetic. There have been no medically confirmed cases of the toxin having spread in Canada.

In its advisory, Health Canada said the symptoms of "distant toxin spread" would include:

• Muscle weakness.
• Difficulties swallowing.
• Pneumonia.
• Speech disorders.
• Breathing problems.

Botox, made by Allergan Inc. of Irvine, Calif., is approved for treating muscle spasms in the neck, eye and foot, muscle pain and excessive sweating in Canada. Botox Cosmetic, which is made by the same company, is approved to treat facial wrinkling.

The drugs use botulinum toxin, which blocks nerve impulses to muscles, causing them to relax.

Health Canada advised people with a history of neurological disorders, swallowing difficulties and breathing problems to be extremely cautious about using the products.

When the U.S. issued its warning, the FDA said the deaths were all among children who were treated for limb spasms, a condition not approved to be treated by these drugs in the U.S. or Canada.

The chances of death are remote because most applications don't require high doses, however, the growing popularity and high price of the treatment could result in the products getting into the hands of wrong people who aren't certified to inject it.

Health Canada said that Botox is the most potent toxin known to man and that if done improperly or abused, it could be dangerous and fatal. It is essential that the government stepped in and started regulating who is allowed to use Botox and under what situations.

Health Canada continues to monitor the safety of Botox products.