Since1mid-October, an advisory committee of the US Food and Drug Administration suggested that PPA be classified as an unsafe drug, a drug ban storm spread rapidly around the world. However, the medical and health departments in different countries have different views on the harm of PPA, and some even differ greatly. What exactly is PPA? Is it really so terrible?

1October 19, an advisory committee of the US Food and Drug Administration issued an urgent proposal to classify PPA as an unsafe drug, and then issued a notice to stop using cold medicines containing PPA on 1 1 June 6. The reason is that studies have shown that taking preparations containing PPA is easy to cause serious adverse reactions such as allergy, arrhythmia, hypertension and insomnia, and may even lead to heart disease and stroke. This decision of the US Food and Drug Administration not only aroused strong repercussions in many pharmaceutical factories, pharmacies and the public in the United States, but also made this drug ban storm spread to the whole world quickly.

Mexican authorities 1 1 month 10 announced that 53 kinds of drugs related to PPA were banned, and Mexicans began to "stay away from cold medicines containing PPA". Countries such as Canada, Malaysia and Singapore have also made similar bans in recent days. China National Medical Products Administration also issued an urgent notice on 1 1 month 16, asking patients to stop taking all cold medicines containing PPA immediately.

PPA is phenylpropanolamine, which is a common ingredient in cold and cough medicine. Its main function is to control the initial symptoms of cold such as stuffy nose and runny nose. Some diet drugs also contain PPA, and PPA is the only over-the-counter diet drug approved by the United States. Drugs containing PPA have been used in the United States for more than 50 years.

However, five years ago, experts from Yale University Medical Research Institute in the United States began to conduct a study on "Hemorrhagic Stroke", aiming to find out whether PPA components in cold medicines and diet pills widely used by people may cause hemorrhagic stroke (or cerebral hemorrhage). The survey found that nearly 4% patients with cerebral hemorrhage had taken drugs containing PPA before stroke, and most of them took cold medicine.

Under normal circumstances, drugs containing PPA will not cause serious adverse reactions, but if the dosage is too large, or the user suffers from hypertension, coronary heart disease, and has a history of stroke, even drugs with low PPA content may lead to systemic vasospasm, coronary artery ischemia, cerebral blood flow obstruction, and dangerous consequences such as high blood pressure or ischemic stroke. That is to say, PPA contained in cold medicine and diet medicine is related to stroke. The US Food and Drug Administration pointed out that although the probability that drugs containing PPA directly cause stroke is not very high, patients should be careful.

Of course, PPA is far less terrible than people think. In response to concerns that some people have taken cold medicines and diet pills containing PPA in the past, the Ministry of Health of Singapore said that PPA components in cold medicines and diet pills will be excreted soon and will not cause long-term harm to the human body. In addition, although millions of people in the United States take drugs containing PPA every year, only 200 to 400 people are found to have a stroke. The results of the survey conducted by the British Drug Safety Commission on PPA are even quite different from those of the Americans.

The British Drug Safety Commission concluded that the evidence linking PPA with cerebral hemorrhage was insufficient. Then a spokesman for the British Ministry of Health held a press conference, claiming that the diet pills containing PPA taken by American women were not sold in Britain. Although drugs used to treat colds and coughs in British pharmacies contain PPA, the maximum daily dosage of patients is only 100 mg, while in the United States it is 150 mg. Therefore, compared with the United States, the risks faced by patients in Britain are almost negligible. The spokesman added: "Of course, we will also conduct a comprehensive investigation."

The Japanese Ministry of Health and Welfare also said that although the United States has begun to recycle some drugs containing PPA, Japan is not prepared to take similar actions for the time being because PPA is widely used in weight loss drugs in the United States and is only licensed for cold drugs in Japan. The probability of cerebral hemorrhage caused by taking cold medicine containing PPA in Japan is very low, and there is only one case at present.

Although PPA has not caused any more serious or extensive damage to human health, the drug ban has caused some losses to some pharmaceutical producers and drug buyers, which makes people start to think deeply about the way of pharmaceutical development and management.

Some experts point out that it is best to diversify the types of drugs for treating a specific disease, such as cold medicine. If many pharmaceutical manufacturers widely use the same chemical component, such as PPA, once it is proved to be harmful to human health, it may trigger a worldwide drug ban. In fact, catching a cold is not without medicine, like many Chinese patent medicines that do not contain PPA in China, which also have a good effect on colds. Many clever foreign manufacturers have developed new cold medicines without PPA before Yale experts put forward the suggestion to ban PPA. These manufacturers suffered the least loss in this PPA trend.

Although the PPA storm made PPA withdraw from the drug stage, it also made the concept of "drug testing" deeply rooted in people's hearts. The relevant personnel in National Medical Products Administration, China said that adverse drug reactions refer to the harmful reactions that have nothing to do with the purpose of drug use or are unexpected under the normal usage and dosage of qualified drugs. Adverse drug reaction detection is one of the important functions of the national drug safety supervision and management department.

Many experts appeal that in order to effectively solve the problem of adverse drug reactions, it is necessary to improve people's correct understanding of it, fully implement the reporting system of adverse drug reactions, establish and improve the monitoring system and legal system, so that the re-evaluation of drugs after listing can be effectively carried out, thus ensuring the safety and effectiveness of people's drug use and avoiding or reducing the possible losses of all parties.