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WASHINGTON (AP) - Federal regulators have warned more than 350 medical practices that Botox they may have received from a Canadian supplier is unapproved and could be counterfeit or unsafe.

The Food and Drug Administration saidin a letter sent last month and released last week that batches of the wrinkle treatment shipped by suppliers owned by pharmacy Canada Drugs have not been approved by the FDA and that the agency cannot assure their effectiveness or their safety.

READ:List of doctors and medical practices sent the letter(PDF)

The FDA said Canada Drugs was previously tied to shipping unapproved and counterfeit cancer drugs.

The agency warned doctors about buying drugs from sources other than licensed U.S. pharmacies. It is the fifth warning the agency has made this year about foreign suppliers providing unapproved drugs.

In February, the agency warned 19 medical practices that they had received a counterfeit version of the cancer drug Avastin. On three more occasions the FDA issued similar warnings about counterfeit Avastin and Altuzan, another brand name for the same drug. The alerts were also primarily targeted at drugs distributed by Canada Drugs.

A request for comment from the drug distributor was not immediately returned.

Drug shortages increased the financial incentives for some pharmacies to provide counterfeit or illegally imported drugs. The drugs subject to warnings have all been injectable treatments typically distributed through medical practices and not directly to patients.

In October, the FDA ordered operators of about 4,100 websites to immediately stop selling unapproved medications to U.S. consumers. The vast majority of those sites were operated by Canada Drugs. The site was still operating Friday.

Genuine Botox is made by Allergan Inc., based in Irvine, Calif. Avastin is made by Roche Holding AG's Genentech unit.

The following medical practices in Tampa Bay were notified by the FDA:

  • Bethel, Adrian
    8146 Cerebellum Way Suite 102
    TrinityFL
  • Florida Joint Replacement & Sports Medicine Center
    3980 Tampa Rd. Ste. 202
    Palm Harbor
  • Golomb, Roger
    1122 Druid Road East
    Clearwater
  • Matheson, Ian
    800 West Martin Luther King Jr. Blvd. Ste. 4
    Tampa
  • Said, Nader
    8115 State Road 54
    New Port Richey
  • Sanchez, Rolando
    4039 W. Kennedy Blvd.
    Tampa
  • Sessa, Alberico
    4143 Clark Rd.
    Sarasota
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