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The MHRA has strengthened its safety warning for all botulinum toxin type A products after “rare cases” of botulism have been linked to their use.

The medicines regulator said it has worked with manufacturers to update information including patient leaflets to highlight the risk of iatrogenic botulism associated with these widely used products.

Patients should seek immediate advice if they experience symptoms such as difficulty swallowing, breathing difficulties or muscle weakness up to four weeks after treatment, said the MHRA.

MHRA chief safety officer Alison Cave said: “Botulinum toxin products are effective for a number of different medical and cosmetic purposes when used correctly. However, these strengthened warnings are an important reminder that, in rare cases, serious side effects can occur.

“It is vital that healthcare professionals and patients are aware of the symptoms of botulism and act quickly if they arise as this is a medical emergency. We also strongly urge the public to avoid unlicensed products and seek treatment only from appropriately qualified practitioners.

“The MHRA continuously monitors the safety of these medicines, including side effects and emerging evidence.”