Ingredient formerly used in over-the-counter cold, cough medicines found to increase stroke risk

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PPA, formerly used as a nasal decongestant for over-the-counter cough and cold medicines and also used as an appetite suppressant, was recalled from use by the FDA in 2005. The Korean research confirms findings that even small doses of PPA can increase the risk of stroke.

The FDA first asked pharmaceutical companies to voluntarily remove the ingredient from medicines as early as November 2000. In November 2005 it re-classified PPA as “unsafe” and removed it from being an ingredient used in over-the-counter medicine.

Many companies have reformulated their American-market cold and cough medicines to remove PPA, but older medicines may still have it.

The research comes from the Seoul National University Hospital. The study aimed to look at whether smaller doses of PPA could trigger a stroke. It had already been proven that the use of PPA in appetite suppressants and diet pills can increase the risk of stroke, thanks to a study by Yale University researchers completed in May 2000.

For the Seoul study, 940 people who had a hemorrhagic stroke were each paired up with two controls. The researchers found that 1.7 percent of the women who had a stroke also had ingested a cold or cough medicine that has PPA, versus just 0.7 percent of the controls. It also was found that longer exposure to PPA increased stroke risk.

In the study, while men are at risk, the percentage of men affected by PPA was a very small amount. The Seoul study is in line with the Yale study in finding that women who have taken PPA are at a higher risk.

The study results can be found in the January 9th issue of Neurology.

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