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Thursday, November 9, 2000

Cold and
diet drugs pulled
from shelves

A decongestant ingredient
has been found to increase
the risk of stroke

By Rosemarie Bernardo

Got a cold? You may have to go to the doctor for medication.

That's because almost all over-the-counter cold medications, except Sudafed, and some appetite suppressants are being removed from pharmacy shelves.

The federal Food and Drug Administration issued a warning Monday that phenylpropanolamine, a decongestant ingredient, poses a risk of strokes among men and women, thus triggering removal of the products off store shelves nationwide.

"We don't want to discover later that it should be pulled," said Adel Etinas, chief pharmacist at Mina Pharmacy in Kapolei. "Better to be safe than sorry."

The FDA said it would take steps to remove phenylpropanolamine from all drug products.

Scientists at Yale University School of Medicine found an association between the ingredient and stroke in women using the drug for weight control and for nasal congestion. Men may also be at risk.

But Dr. Cherylee Chang, co-chairwoman for Operation Stroke of the American Heart Association in Hawaii and medical director for the Neuroscience Institute at the Queen's Medical Center, said, "There is a lot of criticism on the study."

Some parts are questionable, such as whether patients involved in the study had hypertension, and the amount of doses given, Chang said.

Still, "It's much safer to take it off the shelves," she said. She also advised patients to talk with their doctors before taking medication containing the ingredient.

Longs Drugs said yesterday that it was removing from its shelves all over-the-counter diet and cold relief products containing the ingredient. It said alternate remedies are available.

Pharmacist Jim McElhaney of the Pillbox Pharmacy in Kaimuki removed more than six cartons of over-the-counter medication.

Employees at Times Supermarket Ltd. began boxing up Comtrex, Contac, Robitussin, Dimetapp and Dexatrim. Times will pull more items when manufacturers notify it of other items containing phenylpropanolamine, said buyer Dean Takahashi.

Decongestants with the ingredient have remained on the shelves at the Straub Pharmacy on King Street. Each item has been tagged with a florescent orange label to remind pharmacists of remedies containing the ingredient when customers call for refills.

"If the patient insists and is aware of the risk, there is not a mandate to not sell it," said Kristi Nicholson, outpatient pharmacy supervisor. "The FDA has not recalled these products. It has been suggested that they not take them."

In the meantime, staff at Straub Pharmacy suggest patients ask their doctors for an alternate item, Nicholson said.

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