Stroke link brings warning to avoid cold remedies
November 07, 2000

Mary Vallis
National Post, with files from The Canadian Press

U.S. and Canadian health authorities are warning consumers to stay away from more than 60 different over-the-counter cough and cold remedies that contain an ingredient linked to hemorrhagic strokes, especially in young women.

The U.S. Food and Drug Administration said yesterday that it is taking steps to ban non-prescription drugs containing the decongestant phenylpropanolamine (PPA), and it further said that until the ingredient is replaced, people should not use products that include it.

The agency took the step based on a report released in mid-October that linked PPA to deadly hemorrhagic strokes, or bleeding in the brain, among a small percentage of the millions of people who take the drug each day.

Until it meets the legal requirements to ban the ingredient, which will take several months, the agency has asked manufacturers to stop selling products containing PPA immediately.

Health Canada last night said it has decided to follow the FDA's lead and advise people not to use products containing PPA.

''Given the fact that these medications provide only temporary relief, Health Canada is recommending, as a precaution, that consumers do not use any products containing PPA until a full assessment has been completed,'' a department release said.

Roslyn Tremblay, a departmental spokeswoman, said people taking prescription decongestants should check the ingredients with their doctors or pharmacists.

The FDA says PPA could be the cause of deadly hemorrhagic strokes in 200 to 500 people under age 50 -- people who are typically considered too young to be at risk for stroke -- every year.

Products containing the ingredient are already disappearing from stores in Canada.

SmithKline Beecham Consumer Healthcare asked retailers in Canada and the United States to remove all of its products containing PPA from store shelves.

Kevin Foley, a spokesman for the company, stressed that the type of products containing PPA differs in Canada and the United States. In Canada, the company's list includes Sine-Off, all Ornade and some -- but not all -- Contac products.

Canadian consumers have access to nasal decongestants and cough-and-cold remedies that are PPA-free.

In the U.S., PPA in larger doses is also found in over-the-counter diet products. In the 1980s, medical journals cited several cases of young women suddenly suffering hemorrhagic strokes within days of taking appetite suppressants.

Dexatrim, an appetite suppressant sold on both sides of the border, was named by the FDA as one product in question, but the Canadian formulation does not contain PPA.