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As more federal and state lawmakers consider importing lower-cost medicines from Canada, the U.S. Food and Drug Administration warned one of the largest Canadian brokers for violating interstate commerce by sending unapproved and misbranded drugs to Americans.

In a Feb. 26 warning letter to CanaRx, the agency wrote that substituting FDA-approved drugs with unapproved medicines “poses significant health risks to U.S. consumers.” The FDA argued the broker sells drugs subject to a safety program that restricts distribution; some medicines made overseas may have escaped FDA recall procedures; and some drugs have different trade names or dosages.

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