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Creating Waves of Awareness

Dr. Sarfaraz Ahmed alerted me to this information going around the internet

Whenever I have a question about the validity of any information that is passed to me via email I usually check with URBAN LEGENDS first before passing it on to others.

URBAN LEGENDS : Email that gets passed around to friends. Here is the example below:

You may have heard this, or noticed that these products have been removed from the shelves. Discard these Medications


Stop taking anything containing this ingredient. It has been linked to increased hemorrhagic stroke (bleeding in brain) among women ages 18-49 in the three days after starting use of medication. Problems were not found in men, but the FDA recommended that everyone (even children) seek alternative medicine. Alka-Seltzer Plus Children's Cold Medicine Effervescent Alka-Seltzer Plus Cold medicine (cherry or orange) Alka-Seltzer Plus Cold Medicine Original Alka-Seltzer Plus Cold & Cough Medicine Effervescent Alka-Seltzer Plus Cold & Flu Medicine Effervescent Alka-Seltzer Plus Cold & Sinus Effervescent Alka Seltzer Plus Nighttime cold Medicine Effervescent BC Allergy Sinus Cold Powder BC Sinus Cold Powder Comtrex Deep Chest Cold & Congestion Relief Comtrex Flu Therapy & Fever Relief Day & Night Contac 12-Hour Cold Capsules Contac 12 Hour Caplets Coricidin D Cold, Flu & Sinus Dimetapp Cold & Allergy Chewable Tablets Dimetapp Cold & Cough Liqui-Gels Dimetapp DM cold & Cough Elixir Dimetapp Elixir Dimetapp 4 Hour Liqui Gels Dimetapp 4 Hour Tablets Dimetapp 12 Hour Extentabs Tablets Naldecon DX Pediatric Drops Permathene Mega-16 Robitussin CF Tavist-D 12 Hour Relief of Sinus & Nasal Congestion Triaminic DM Cough Relief Triaminic Expectorant Chest & Head Congestion Triaminic Syrup Cold & Allergy Triaminic Triaminicol Cold & Cough Acutrim Diet Gum Appetite Suppressant Plus Dietary Supplements Acutrim Maximum Strength Appetite Control Dexatrim Caffeine Free Dexatrim Extended Duration Dexatrim Gelcaps Dexatrim Vitamin C/Caffeine Free

Update: Most if not all of the products listed above which formerly contained phenylpropanolamine hydrochloride have been reformulated to eliminate the ingredient. Consumer questions about phenylpropanolamine and its potential health hazards may be directed to the U.S. Food and Drug Administration at 1-888-INFO-FDA

Some manufacturers of over-the-counter medicines containing phenylpropanolamine have offered refunds to consumers who purchased the products before they were voluntarily recalled in late

To inquire about the availability of such refunds, dial the 800-number for consumer questions listed on the product packaging.


This email has it mostly right. In November 2000, the FDA issued a public health advisory about phenylpropanolamine hydrochloride (PPA) the drug mentioned in the email. This drug is found in many over the counter (OTC) medicines, specifically in cold and flu remedies, as well as appetite suppressants. The drug will likely be banned, but because this process takes time, the FDA issued the health advisory in the meantime and manufacturers are voluntarily recalling and/or reformulating medicines containing PPA.

The main problem with this drug is that it elevates your risk of having a hemorrhagic stroke, especially with (but not limited to) first time use among women. Because the uses of PPA are not serious enough to warrant taking even that small chance, the FDA recommends that you stop taking any medications containing the drug.

Rather than looking at a limited list such as the one contained in the above email, you'd be better off checking the package of any cold, flu or appetite suppressant medication for the drug, which will appear in the list of active ingredients and may be listed as phenylpropanolamine, phenylpropanolamine hydrochloride, or phenylpropanolamine bitartrate. Many manufacturers offer several formulations of their cold and flu remedies, some of which do not contain PPA.

Pseudoephedrine is an effective alternative to PPA for use in cold and flue preparations, but unfortunately, there is no approved alternative OTC drug for use in appetite suppressants.

Therefore, if you are using any OTC medications to suppress your appetite for weight loss or other reasons, you should stop using the medicine and talk to your doctor about getting a prescription drug instead.

Additionally, some prescription decongestants and cold and flu preparations contain PPA, so if you are using any prescription medicines for these purposes, talk to the prescribing doctor to see if you should continue using the medicine.

One word of caution: Though the email states your risk is for "increased hemorrhagic stroke (bleeding in brain) among women ages 18-49 in the three days after starting use of medication," don't think you are safe if you've used the drug for longer than three days. The three-day window was merely one of the guidelines used in the study that prompted the health advisory; for the study, they defined PPA exposure as having used PPA within three days prior to the stroke. Risk of stroke may be present after three days of use.

For detailed information, see the final report of the Hemorrhagic Stroke Project, Web-published by the FDA.
As always, your best resources for reliable information on medicines and medical conditions are your own physician and pharmacist.

Phenylpropanolamine and Strokes - was it all a hoax
Published: February 01, 2001 by Michael Dorausch, D.C.

What is Phenylpropanolamine used for?
Phenylpropanolamine (PPA) is a chemical that is in many over the counter and prescription cold and cough medications, nasal decongestants, and over the counter appetite suppressant and weight loss products.

Why was Phenylpropanolamine Recalled (or why should it) ?
Phenylpropanolamine sales were banned November 6, 2000 because of concerns over the increased risk of hemorrhagic stroke found to occur especially in younger women.

PPA does continue to be available over the counter because the FDA cannot control over the counter drugs. Phenylpropanolamine continues to endanger people who use products containing PPA. Each year billions of doses of over the counter medicine containing PPA are used.

What Makes Phenylpropanolamine a dangerous Drug ( side effects):
Hemorrhagic strokes

Underdeveloped and developing countries like India had become a dumping ground for globally banned drugs like DROPERIDOL, ANALGIN, PHENYLPROPANOLAMINE (Vicks action 500, D cold), etc. And nowadays their production has been increasing like anything.

Most of the buyers are unaware of the after effects caused by its consumption. Please go through the below list of few killers to find out whether they used to serve you on self-medication.

ANALGIN:- Brand name: Novalgin

Use: Works as a pain-killer. Banned for / Reason: Bone marrow depression.

CISAPRIDE:- Brand name: Ciza, Syspride

Use: Used against constipation and acidity. Banned for / Reason: irregular heartbeat

DROPERIDOL:- Brand name: Droperol

Use: Anti depressant. Banned for / Reason: Irregular heartbeat

FURAZOLIDONE:- Brand name: Furoxone, Lomofen

Use: Antidiarrhoeal. Banned for / Reason: Causes Cancer

NIMESULIDE:- Brand name: Nise, Nimulid

Use: used for fever and as a painkiller Banned for / Reason: Liver failure

NITROFURAZONE:- Brand name : Furacin

Use: Used as an antibacterial cream. Banned for / Reason: Cancer

PHENOLPHTHALEIN:- Brand name: Agarol

Use: Laxative Banned for / Reason: Cancer

PHENYLPROPANOLAMINE:- Brand name: D’cold, Vicks Action-500

Use: Used widly for cold, cough, etc Banned for / Reason: stroke.

OXYPHENBUTAZONE:- Brand name: Sioril

Use: Non-steroidal anti-inflammatory drug. Banned for / Reason: Bone marrow depression

PIPERAZINE:- Brand name: Piperazine

Use: Anti-worms Banned for / Reason: Nerve damage.

QUINIODOCHLOR:- Brand name: Enteroquinol

Use: Anti-diarrhoeal Banned for / Reason: Damage to sight


Central Drugs Standard Control Organization Dte.GHS, Ministry of Health and Family Welfare, Government of India


Ministry may review sale of 12 'risky' drugs

Drugs Technical Advisory Board (DTAB) is likely to deliberate on 12 drugs which are banned in several parts of the world but are still allowed in India. The DTAB, which is the highest body on technical matters regarding the pharmaceuticals segment, under the Union ministry of health, is planning to discuss the matter in its meeting this month, said a person closely associated with the body.

Drugs including those like nimesulide (pain/fever, side-effect -- liver damage), droperidol (anti-depressant, side-effect-irregular heart beat), furazolidone (anti-diarrhoeal, side-effect-cancer), nitrofurazone (anti-bacterial, side-effect -- cancer) are some which have been banned in several parts of the world, including the US and the UK.

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All the drugs listed as banned were developed and marketed on evidence-based research. What kind of evidence was this?
Good point!


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