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Cold disinterest

R. Desikan

Phenylpropanolamine (PPA) is a common ingredient in cough and cold medications as well as several over-the-counter (OTC) products. It is also used as a nasal decongestant. Recent researches indicate that PPA is dangerous. A letter from Dr. C.J. Shishoo o f the Ahmedabad-based Testing Organisation for Research in Chemicals and Health Hazards (TORCH) lists the characteristics of PPA and explains why it is inappropriate for use in medical formulations.

``PPA is an a-adrenergic receptor which produces vasoconstriction by stimulating a-receptors within the mucosa of the respiratory tract. It shrinks mucosal membranes and clears nasal congestion. PPA, like amphetamine, is also used as an appetite suppress ant. The mechanism, though different, involves chemical mediators released in the central nervous system. Symptomatic drugs such as PPA, pseudoephedrine and phenylephrine should be used with caution in patients with hypertension, diabetes, ischemic heart disease, increased intraocular pressure and prostatic hypertrophy. Also, PPA should not be taken simultaneously with other products containing phenylephrine, pseudoephedrine or amphetamine.

``In a recent Yale study funded by the pharma industry, scientists have found that PPA increases the risk for stroke in women aged 18-49 years. Even men may not be free from risk. In the United States, the FDA Non-Prescription Drug Advisory Committee has concluded that there is an association between PPA and haemorrhagic stroke. It has recommended that PPA should not be considered safe for OTC use. The panel has estimated that the withdrawal of PPA from the market could prevent 200-500 haemorrhagic stro kes in the US. The FDA is now taking steps to remove PPA from all drug products and has requested drug companies to discontinue marketing products containing PPA.

``In India, more than 50 manufacturers use PPA in cough and cold formulations. Many of these are sold as OTC drugs. The package does not list any adverse drug reactions. Nor are there warnings to prevent its use by patients suffering from diabetes and ca rdiac diseases. The drug is liable to interfere with the flow of urine in patients afflicted by prostatic hypertrophy.''

Consumers are bombarded by numerous advertisements, extolling the virtues of cough and cold syrups. Some even promise instant relief. But how many of us bother to check on the ingredients that go into making these `magic potions'?

I am amazed at the impunity with which the Government issues manufacturing licences for these dangerous medical products. Are human lives and health so dispensable to our rulers?

The author is former chairman, Federation of Consumer Organisations, Tamil Nadu. He can be reached at rdesikan@vsnl.com