Panamanian authorities recalled a popular high blood pressure medicine after investigations linked it to a mystery illness that has killed 19 people.
Health Minister Camilo Alleyne said early tests on Lisinopril tablets had not detected toxic agents, but the drug was being recalled from pharmacies, hospitals and private clinics nationally as a precaution.
He said nine out of 30 mainly elderly people who have fallen sick with the mystery illness over the past month had been taking Lisinopril tablets. Of those nine, five had died.
"The preliminary tests results were satisfactory," Dr Alleyne told a news conference.
"However, the latest cases have the use of this medicine in common, so we are recommending its provisional withdrawal from the national market and from public and private health facilities as a preventative measure until further notice."
Health officials said the Spanish manufacturer of the tablets was sending a team of representatives and scientists to Panama to help with the investigation. Lisinopril, used to treat hypertension and heart failure, is a generic drug made by several companies.
The tablets sold in Panama are made by Spain's Normon SA, a laboratory specialising in generic medicines, Panamanian health officials said.
"The company has already sent senior executives, representatives and technical staff from its headquarters and they are asking to meet," the head of Panama's public health insurance system, Rene Luciani, said.
The tablets, which had complied with all Panama's health and safety regulations, first came on the Panamanian market in mid-August, shortly before the outbreak of the mystery illness.
Norman sells its drugs in Europe, Central and South America, Asia and Africa. A company spokesperson could not be immediately reached for comment.
A total of 19 people have died from Panama's mystery illness - which starts with nausea, fever, diarrhea and weakness, and soon progresses to acute kidney failure, partial paralysis and death. Another 11 people are sick.
The illness has struck mainly men over 60 being treated for high blood pressure, diabetes and kidney disorders. Most were undergoing multiple treatments, but investigators noticed several had Lisinopril tablets in common, raising the possibility there could be a contaminated batch.