What would you say if your income depended on an 18-billion-a-year over-the-counter industry and you found out that the Food and Drug Administration of the United States is about to ban your drug? That's just what happened when a special advisory panel to the FDA found that phenypropanolamine or PPA is not safe. More than 6 billion doses of PPA were bought by consumers last year in Dexatrim to suppress appetite, Alka Seltzer Plus Cold Medicine to shrink your stuffy nose. The FDA estimate that PPA causes 200 to 500 people between 18 and 49 of age to suffer strokes each year.

Phenylpropanolamine is a derivative of amphetamine that raises blood pressure and causes rapid heart beats. This year alone, there were eight reports of Phenylpropanolamine causing strokes, heart attacks and skin rashes. You have to realize that the incidence of strokes caused by phenylpropanolamine is so low that it appears to be ridiculous to ban that drug. However, you would probably not get into a plane that had one chance in 20,000 of crashing, so I guess you may be wary of phenylpropanolamine. The chance of suffering a side effect from this drug is extremely low.

1) Fixed drug eruption due to phenylpropanolamine hydrochloride [letter] Heikkila H , Kariniemi AL , Stubb S Br J Dermatol 2000 Apr;142(4):845-7.

2) Myocardial infarction associated with phenylpropanolamine. Oosterbaan R , Burns MJ Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. J Emerg Med 2000 Jan;18(1):55-9.

3) Exacerbation of psychosis by phenylpropanolamine [letter] Goodhue A , Bartel RL , Smith NB Am J Psychiatry 2000 Jun;157(6):1021-2 .

4) Phenylpropanolamine-associated intracranial hemorrhage in an infant [letter]Hamilton RS , Sharieff G Am J Emerg Med 2000 May;18(3):343-5.

5) Intracerebral hemorrhage in a young woman with arteriovenous malformation after taking diet control pills containing phenylpropanolamine: a case report. Chung YT , Hung DZ , Hsu CP , Yang DY , Wu TC Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan, ROC. Chung Hua I Hsueh Tsa Chih (Taipei) 1998 Jul;61(7):432-5.

6) Over-the-counter sympathomimetics: a risk factor for cardiac arrhythmias in pregnancy. Onuigbo M , Alikhan M Department of Internal Medicine, Greater Baltimore Medical Center, MD 21204, USA. South Med J 1998 Dec;91(12):1153-5.

7) Cerebral infarction in an adolescent girl following an overdose of paroxetine and caffedrine combined with theodrenaline. Conde Lopez VJ , Ballesteros Alcalde MC , Blanco Garrote JA , Marco Llorente J Departamento de Psiquiatria, Hospital Clinico Universitario, Valladolid. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1998 Sep-Oct;26(5):333-8.

Checked 8/9/05

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