Boxed warning (distant spread of toxin effect): Postmarketing reports indicate that the effects of MYOBLOC and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. Spread of toxin effects, swallowing and breathing difficulties can lead to death. Seek immediate medical attention if respiratory, speech or swallowing difficulties occur. MYOBLOC potency units cannot be compared to or converted into units of other botulinum toxins. Patients with neuromuscular disorders should be monitored closely for swallowing/breathing difficulty