Phenylpropanolamine and the hemorrhagic stroke: A new search for the culprit

Based primarily on the Final Report of the Hemorrhagic Stroke Project (HSP) released on May 2000,[3,4] the Food and Drug Administration (FDA) had concluded that there is an association between PPA and hemorrhagic stroke. In November 2000, the FDA formally recommended that PPA not be considered safe for the OTC use and asked the drug manufacturers to voluntarily discontinue marketing any products containing PPA.[5] As a consequence, in most countries, all of OTC and prescription diet aids, as well as cough and cold remedies containing PPA, were discontinued or reformulated with another decongestant. Ephedrine and pseudoephedrine were the mostly used substitutes as they share the pharmacological properties of PPA and are approximately similar in potency except that PPA causes less central nervous system stimulation