Withdrawal Of Phenylpropanolamine(PPA) Products

10 Nov 2000

 The Ministry of Health has asked all pharmaceutical companies marketing products containing phenylpropanolamine (PPA) to voluntarily withdraw and discontinue the distribution of these products in Singapore. This is a precautionary measure in line with the recent call by the US Food and Drug Administration (FDA) for voluntary discontinuation of marketing of such products in the USA.

The FDA's decision was based on a recent study by the Yale University, USA, that concluded there was an increased risk of haemorrhagic stroke from the ingestion of PPA, especially with PPA slimming products. PPA is a common decongestant found in combination with other drugs in many cough and cold medicines. Such drugs are available in Singapore only from a pharmacist as "Pharmacy-only" items. On the other hand, PPA-containing products are available in the US as "over the counter" products without the need for a prescription from a doctor or supervision of a pharmacist. In the US, PPA is also available as a single ingredient for use as a slimming product. Such slimming products have not been available for sale in Singapore.

Since the access to PPA products in Singapore is more limited and controlled, the Ministry has decided that a precautionary approach is adequate at this stage to protect public health. Having reviewed the products registered for the treatment of coughs and colds in Singapore, the Ministry assures the public that there are sufficient safer alternative non-PPA-containing preparations available.

The Ministry will be advising all doctors and pharmacists to dispense alternative non-PPA-containing products for their patients .

The public is advised to consult a doctor or pharmacist before taking any PPA-containing products. In addition, patients with high blood pressure are advised to avoid PPA-containing preparations as hypertension itself is known to increase the risk of stroke.

The Ministry wishes to reassure the public that there is no risk of adverse effects once PPA-containing products are no longer being taken. Patients who have previously taken PPA-containing products do not have to be worried about their health as there are no long-term adverse effects from PPA-containing products since these products are quickly eliminated from the body.

The PPA-containing cough and cold medications registered in Singapore are listed in the Annex.