Postpartum Phenylpropanolamine-Induced Intracerebral Hemorrhage Phenylpropanolamine-induced vasculitis and related intracerebral hemorrhage has moved from the spotlight it occupied following its withdrawal from the market at the end of 2000 after the Food and Drug Administration ruled that it was not safe and effective, but the risk from medicines purchased prior to that time and still in the possession of the public can still pose a health hazard. We present the case of a patient who developed intracerebral hemorrhage following phenylpropanolamine ingestion post-partum 4 years following the recall, as well as her difficult recovery process. This case emphasizes the point that physicians should consider phenylpropanolamine when evaluating young females with few risk factors for stroke.
Changes in blood pressure following escalating doses of phenylpropanolamine and a suggested protocol for monitoring This prospective, cross-over, blinded study evaluated the effect of various doses of phenylpropanolamine (PPA) on blood pressure in dogs. Dogs were randomized to receive a placebo or 1 of 3 dosages of immediate release PPA, q12h for 7 days [1 mg/kg body weight (BW), 2 mg/kg BW, or 4
+ PFMT + tolterodine; PFMT + tolterodine; PFMT + oxybutynin; PFMT + trospium 2nd x x x x Anticholinergics Darifenacin, fesoterodine, flavoxate, oxybutynin, phenylpropanolamine, pilocarpine, propantheline, propiverine, solifenacin, tolterodine, trospium 2nd x x x x x Anticholinergics + hormones Phenylpropanolamine + estrogen 2nd . x . . x BTX (onabotulinum toxin A) . 3rd x x x x x Antiepileptics
of the evidence using the GRADE approach. We categorised the included trials according to the active ingredients. We identified 30 studies (6304 participants) including 31 treatment comparisons. The control intervention was placebo in 26 trials and an active substance (paracetamol, chlorphenindione + phenylpropanolamine + belladonna, diphenhydramine) in six trials (two trials had placebo as well as active . There is no evidence of effectiveness in young children. In 2005, the US Food and Drug Administration issued a warning about adverse effects associated with the use of over-the-counter nasal preparations containing phenylpropanolamine.
)*Goal is symptomatic therapy* * Neti Pot * Local decongestant – Topical agents should not be used longer than 5 days, or increase risk of rhinitis medicamentosa * Oral decongestants are no better than topical, and should only be used if patients cannot use topical. (e.g., phenylpropanolamine or pseudoephedrine) Avoid in poorly controlled hypertension or concurrent use of tricyclic antidepressants