[an error occurred while processing this directive]
By WES ALLISON
© St. Petersburg Times, published November 8, 2000
ST. PETERSBURG -- Pharmacists answered questions Tuesday about alternatives for unclogging that stuffy nose now that many of the old standbys have been deemed unsafe.
Meanwhile, Largo-based Eckerd Drug Stores joined the nation's other major chains in pulling scores of products that contain phenylpropanolamine, or PPA, from its shelves.
Eckerd's announcement came a day after the Food and Drug Administration advised people not to take products containing PPA because the compound has been linked to an increased risk of hemorrhagic stroke in people younger than 50, especially women.
PPA is the active ingredient in hundreds of popular over-the-counter cold and cough remedies, including some versions of Contac, Dimetapp and Triaminic. It is used in higher doses in appetite-suppressants such as Dexatrim and Acutrim.
The FDA plans to ban PPA, but that process can take months. In the meantime, it has asked manufacturers to quit marketing the drugs. Drugstore giant Walgreens, Eckerd's top competitor in the Tampa Bay market, began pulling pills from its shelves on Monday, as did CVS.
"Eckerd prides itself on complying in a timely manner with any and all recommended product bans and/or recalls, and we are proud to voluntarily initiate this removal to protect our customer's health," said Enzo Cerra, Eckerd's senior vice president of merchandising.
The company's new position, announced first thing Tuesday morning, marked a quick U-turn. At 5 p.m. Monday, Eckerd issued a statement saying it would continue to carry the products and "is proceeding cautiously as we move into the cough and cold season."
Albertsons supermarkets also announced late Tuesday it would begin pulling products today.
The FDA issued Monday's warning after an advisory panel agreed unanimously that PPA is associated with an increased risk of hemorrhagic stroke, or bleeding in the brain, and the agency says banning its use should prevent 200 to 500 strokes a year.
The decision was based largely on a recent Yale University study of young stroke victims that showed a higher percentage of them had used products with PPA than the general population, although the risk was small. The risk was identified only within the first three days of use, so people who have used PPA in the past have no cause for concern.
Those who want to buy medicines that contain PPA despite the warnings can. Local grocery stores, including Publix, continued to sell the products Tuesday, as did some independent and online pharmacies.
Meanwhile, doctors' staffs and pharmacists said they fielded some questions about the warning, but not as many as they expected. That might be because few colds are going around and the presidential election is overshadowing other news, they said.
The FDA's advisory also was pretty clear: Check the label. If phenylpropanolamine is a key ingredient, don't use it. If it is, find another drug.
"I don't think it's a big deal with most people around here," said Jim Alonso, owner and pharmacist at the Prescription Shop in downtown St. Petersburg. "Alternatives are readily available."
Several pharmacists said they are recommending products that use pseudoephedrine, such as Sudafed, Actifed or their generic equivalents, which are available in doses for kids and adults. Other common brands, including Dimetapp, Contac and Triaminic, come in versions that don't contain PPA.
John Kelley, pharmacist and owner of the Apothecary in Gulfport, said he recommends some natural remedies as well, and urges parents to ask their pediatrician or pharmacist before choosing a drug for a child.
"There's nothing better than communication when it comes to medicating children," Kelley said. "You shouldn't be doing that on your own anyway. You're always weighing the risk to the benefit."