An advisory committee to the US Food and Drug Administration is recommending that phenylpropanolamine (PPA), an ingredient found in many common over-the-counter cough and cold medications and appetite suppressants, be reclassified as unsafe, due to the fat that it may increase the risk of hemorrhagic stroke.
Some of the products that would be affected if the FDA opts to follow the panel's advice include drugs sold under the names:
"Case reports have linked exposure to PPA to the occurrence of hemorrhagic stroke," writes Dr. Ralph I. Horwitz from Yale University's School of Medicine, and colleagues in the Hemorrhagic Stoke Project report.
In Western countries, stroke is the third most common cause of death and the second most common cause of neurologic disability after Alzheimer's disease.
Hemorrhagic strokes are characterized by bleeding in the brain. Symptoms typically begin abruptly with a headache, followed by steadily increasing neurological symptoms, the type of which are dependent upon the location of the brain where the bleeding occurs.
Rsearchers studied over 2000 adults aged 18 to 49, over a 5-year period, including 702 individuals who were hospitalized due to a stroke.
Stroke patients were 50% more likely than the control subjects to have been exposed to a PPA-containing substance within three days of their stroke.
Of course, drug manufacturers are disputing the study's findings. The Consumer Healthcare Products Association (CHPA) is a national trade association that represents US manufacturers and distributors of nonprescription, over-the-counter medicines and dietary supplements. In a released statement, CHPA says " ... the hemorrhagic stroke project did not establish a causal relationship between PPA and hemorrhagic stroke."
They also maintain that possible errors in memory recall by the patients may have skewed the study results. "For example, a participant could incorrectly recall that they took product A-which contains PPA-when in fact, they took product B-which contains no PPA," according to the CHPA.
CHPA asserts the safety and effectiveness of PPA, but allows that it "may consider, if warranted, recommending additional research to confirm the safety of cough/cold medications and appetite suppressants containing PPA."
PPA has a long standing history of associations with strokes. This is nothing new. What is a mystery to me is why this drug has been kept on the market. Sudafed (pseudoephedrine) is clearly safer and just as effective. So one clearly needs to avoid this drug. A better strategy would be to consider quercitin, a bioflavanoid with potent anti allergy properties. However the best strategy would be to optimize your immune system so you don't get sick in the first place. Restricting the grains, eliminating sugar and drinking one quart of pure water for every fifty pounds of body weight is a huge start in the right direction. (more diet info).
PPA is also not the first cough medicine to have serious adverse effects come to light. One cough suppressant, Dextromethorphan, also available over-the-counter, was shown to cause birth defects when taken during pregnancy.
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