- The Washington Times - Wednesday, November 8, 2000

Local chain stores that carry nonprescription cold and weight-loss medications have stopped or are about to stop selling products that contain an ingredient that has been found to cause strokes.

Giant Food joined CVS Pharmacy, Rite Aid and Walgreens Co. in taking the products containing phenylpropanolamine, or PPA, off the shelves. PPA has been found to cause hemorrhagic strokes, or bleeding in the brain.

A Safeway spokesman said the company's stores also are likely to stop selling drugs with PPA beginning today.

The Food and Drug Administration (FDA) on Monday warned Americans about the hazard of consuming the chemical, and asked drug makers to find a replacement for PPA for future drug production.

Many popular over-the-counter cold, sinus and allergy medications, such as Alka-Seltzer Cold & Sinus effervescent tablets, Dimetapp Cold & Allergy, Tavist-D Allergy/Decongestant and Robitussin CF contain PPA.

Americans took about 6 billion doses of drugs containing the chemical last year. Some 98 percent of drugs with PPA sold last year were cough and cold products. The rest were all diet aids, including Dexatrim and Acutrim.

The FDA said consumers should read the labels on medication containers and buy alternative drugs that do not contain PPA. Such drugs include all types of Tylenol, Sudafed, TheraFlu, Excedrin, NyQuil and DayQuil, Cepacol and Advil. Some types of Alka-Seltzer and Robitussin are also PPA-free.

"The sad thing is … this is a decision that could have been made 10 years ago," said Larry Sasich, pharmacist at the health research group of Public Citizen, a consumer watchdog. "So this is really a drug that should have come off the market 10 years ago."

The FDA recently held a meeting to discuss the use of drugs with PPA. One of the doctors present estimated that some 200 to 5,000 strokes per year are caused by the intake of PPA products, Mr. Sasich said. Young women are particularly susceptible.

The region's largest pharmacy, CVS, has been pulling products containing PPA off the shelves since Monday night. The Woonsocket, R.I.-based chain has 49 stores in the District of Columbia, 245 throughout Virginia and 170 in Maryland.

Rite Aid pharmacies made the same move Monday. The Harrisburg, Pa.-based chain has 18 stores in the region, eight of which are in the District.

As of yesterday, consumers also were unable to purchase drugs with PPA at stores of the Deerfield, Ill.-based chain Walgreen Co., where the registers were programed not to process sales of such medications.

Locally, Walgreens' largest presence is in Baltimore, where it has four stores. It has none in the District. There are 24 Walgreens stores in Virginia, but none closer than Newport News.

Grocery stores like Giant and Safeway held off making a decision Monday. But Giant proceeded with the action yesterday morning, and Safeway was finalizing its decision in the afternoon.

Grocers typically stop selling products only after the manufacturer issues a recall, and no such massive call had been made by drug makers.

Only SmithKline Beecham PLC had issued a recall. The pharmaceutical giant has asked retailers not to sell its Contac cold capsules, its only product that contains PPA. SmithKline also said it already has stopped making that version of the medicine.

At Giant stores, employees took the drugs with PPA into back rooms.

"We are pulling everything with PPA," said Barry Scher, company spokesman. "We are doing it out of an abundance of caution. The product will be placed in our back room until we receive notification from the manufacturers. We are also posting signs for our customers to inform them."

Giant's 178 stores are in the District, Virginia, Maryland, Delaware and New Jersey. The majority, about 115, are in the Washington area.

Craig Muckle, spokesman for Safeway, said the company most likely would stop selling 75 items that contain PPA today. Safeway has 126 stores in the area.

The FDA based its decision to warn consumers about PPA on a Yale University School of Medicine study that found patients between the ages of 18 and 49 who used products with PPA were more likely to suffer from hemorrhagic strokes than those who were PPA-free.

Diet pills were especially dangerous, the study suggested, saying that the risk of stroke was 16 times higher in people who use weight-loss pills with PPA than in those who do not.

Hemorrhagic strokes are very uncommon. They can be deadly or leave survivors disabled.

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