The Ministry of Health has asked all pharmaceutical companies marketing products containing phenylpropanolamine (PPA) to voluntarily withdraw and discontinue the distribution of these products in Singapore. This is a precautionary measure in line with the recent call by the US Food and Drug Administration (FDA) for voluntary discontinuation of marketing of such products in the USA.
The FDA's decision was based on a recent study by the Yale University, USA, that concluded there was an increased risk of haemorrhagic stroke from the ingestion of PPA, especially with PPA slimming products. PPA is a common decongestant found in combination with other drugs in many cough and cold medicines. Such drugs are available in Singapore only from a pharmacist as "Pharmacy-only" items. On the other hand, PPA-containing products are available in the US as "over the counter" products without the need for a prescription from a doctor or supervision of a pharmacist. In the US, PPA is also available as a single ingredient for use as a slimming product. Such slimming products have not been available for sale in Singapore.
Since the access to PPA products in Singapore is more limited and controlled, the Ministry has decided that a precautionary approach is adequate at this stage to protect public health. Having reviewed the products registered for the treatment of coughs and colds in Singapore, the Ministry assures the public that there are sufficient safer alternative non-PPA-containing preparations available. The Ministry will be advising all doctors and pharmacists to dispense alternative non-PPA-containing products for their patients.
The public is advised to consult a doctor or pharmacist before taking any PPA-containing products. In addition, patients with high blood pressure are advised to avoid PPA-containing preparations as hypertension itself is known to increase the risk of stroke.
The Ministry wishes to reassure the public that there is no risk of adverse effects once PPA-containing products are no longer being taken. Patients who have previously taken PPA-containing products do not have to be worried about their health as there are no long-term adverse effects from PPA-containing products since these products are quickly eliminated from the body.
The PPA-containing cough and cold medications registered in Singapore are listed below.
No. | Name of Product | Active Ingredients | Strength |
1 | ACCOL TABLET | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 4 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
2 | ALLERIN EXPECTORANT | DIPHENHYDRAMINE HCl | 12.5 mg/5 ml |
GUAIPHENESIN | 50 mg/5 ml | ||
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
SODIUM CITRATE | 180 mg/5 ml | ||
3 | ANTIKOF SYRUP | TRIMEPRAZINE TARTRATE | 2.5 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 10 mg/5 ml | ||
GUAIPHENESIN | 25 mg/5 ml | ||
IPECACUANHA TINCTURE | 0.015 ml/5 ml | ||
4 | BEACOGEN TABLETS | PARACETAMOL | 500 mg |
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
DEXCHLORPHENIRAMINE MALEATE | 1 mg | ||
5 | BEAFLU TABLETS | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 2 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
6 | BROMANATE ELIXIR | BROMPHENIRAMINE MALEATE | 2 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
7 | COLD SPECIAL SYRUP | BROMPHENIRAMINE MALEATE | 2 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
8 | COLDACHE TABLET | PARACETAMOL | 500 mg |
PHENYLPROPANOLAMINE HCl | 15 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
9 | CONTAC 400 CAPSULE | PHENYLPROPANOLAMINE HCl | 50 mg |
CHLORPHENIRAMINE MALEATE | 4 mg | ||
10 | CORITAB TABLET | PARACETAMOL | 500 mg |
PHENYLPROPANOLAMINE HCl | 25 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
11 | CORITUSSAL SYRUP | DEXTROMETHORPHAN | 120 mg/100 g |
PHENYLPROPANOLAMINE | 300 mg/100 g | ||
CARBINOXAMINE | 24 mg/100 g | ||
12 | COUGH SPECIAL SYRUP | TRIPROLIDINE HCl | 1.25 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
CODEINE PHOSPHATE | 10 mg/5 ml | ||
13 | CTP COUGH FORMULA | TRIPROLIDINE HCl | 1.25 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
CODEINE PHOSPHATE | 10 mg/5 ml | ||
14 | DE- COLD ELIXIR | BROMPHENIRAMINE MALEATE | 4 mg/10ml |
PHENYLPROPANOLAMINE HCL | 25 mg/10ml | ||
15 | DECOLDIN TABLET | PARACETAMOL | 480 mg |
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
16 | DECOLGEN FORTE TABLET | ACETAMINOPHEN | 500 mg |
PHENYLPROPANOLAMINE HCl | 25 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
17 | DECOLGEN LIQUID | ACETAMINOPHEN | 300 mg/15 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/15 ml | ||
CHLORPHENIRAMINE MALEATE | 1 mg/15 ml | ||
18 | DECOLGEN TABLET | ACETAMINOPHEN | 300 mg |
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
CHLORPHENIRAMINE MALEATE | 1 mg | ||
ASCORBIC ACID | 25 mg | ||
19 | DELIX PAEDIATRIC LINCTUS | PHENYLPROPANOLAMINE HCl | 10 mg/5 ml |
PROMETHAZINE HCl | 1.5 mg/5 ml | ||
PHOLCODINE CITRATE | 1.5 mg/5 ml | ||
20 | DEXEDYL LINCTUS | DEXTROMETHORPHAN HBr | 15 mg/10 ml |
PHENYLPROPANOLAMINE HCl | 15 mg/10 ml | ||
CHLORPHENIRAMINE MALEATE | 2 mg/10 ml | ||
21 | DHAFLU TABLET | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 3 mg | ||
PHENYLPROPANOLAMINE HCl | 20 mg | ||
CAFFEINE ANHYDROUS | 30 mg | ||
22 | DIMETAPP ELIXIR | PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml |
BROMPHENIRAMINE MALEATE | 2 mg/5 ml | ||
23 | DIMETAPP EXTENTABS | BROMPHENIRAMINE MALEATE | 12 mg |
PHENYLPROPANOLAMINE HCl | 75 mg | ||
24 | DYNACOLIN TABLET | PARACETAMOL | 500 mg |
PHENYLPROPANOLAMINE HCl | 25 mg | ||
CHLORPHENIRAMINE MALEATE | 4 mg | ||
25 | EAZKOFF COUGH AND COLD LINCTUS | PHENYLPROPANOLAMINE HCl | 10 mg/5 ml |
TRIMEPRAZINE TARTRATE | 2.5 mg/5 ml | ||
GUAIPHENESIN | 25 mg/5 ml | ||
26 | FEBRICOL ELIXIR | PARACETAMOL | 162.5 mg/5 ml |
CHLORPHENIRAMINE MALEATE | 1 mg/5 ml | ||
PHENYLPROPANOLAMINE HCl | 6.25 mg/5 ml | ||
27 | FEBRICOL TABLET | PARACETAMOL | 500 mg |
PHENYLPROPANOLAMINE HCl | 15 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
28 | FLU FORTE SYRUP | CHLORPHENIRAMINE MALEATE | 4 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 25 mg/5 ml | ||
29 | FLUTAMIN COLD FORMULA | CHLORPHENIRAMINE MALEATE | 4 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 25 mg/5 ml | ||
30 | GUARDIAN COUGH & COLD SYRUP | GUAIFENESIN | 50 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 6.25 mg/5 ml | ||
31 | MEHISDIN SYRUP | CHLORPHENIRAMINE MALEATE | 2 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
SODIUM CITRATE | 40 mg/5 ml | ||
32 | MENDICOF SYRUP | DEXCHLORPHENIRAMINE MALEATE | 2 mg/5 ml |
DEXTROMETHORPHAN HBr | 15 mg/5 ml | ||
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
33 | MILIDON-CO TABLET | CHLORPHENIRAMINE MALEATE | 2 mg |
PARACETAMOL | 500 mg | ||
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
34 | NASATAB TABLET | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 4 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
35 | NOBIS TABLET | BROMPHENIRAMINE MALEATE | 4 mg |
PHENYLPROPANOLAMINE HCl | 25 mg | ||
36 | P3 COUGH SYRUP | PHOLCODINE | 3 mg/5 ml |
PROMETHAZINE HCl | 3 mg/5 ml | ||
PHENYLPROPANOLAMINE HCl | 6 mg/5 ml | ||
37 | PAEDICOF SYRUP | DEXCHLORPHENIRAMINE MALEATE | 0.5 mg/5 ml |
DEXTROMETHORPHAN HBr | 5 mg/5 ml | ||
PHENYLPROPANOLAMINE HCl | 6.25 mg/5 ml | ||
38 | PANAFLU PLUS TABLET | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 2 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
CAFFEINE ANHYDROUS | 15 mg | ||
39 | PANAFLU TABLET | PARACETAMOL | 300 mg |
CHLORPHENIRAMINE MALEATE | 2 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
40 | PARAMINE TABLET | PARACETAMOL | 500 mg |
PHENYLPROPANOLAMINE HCl | 15 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
41 | PARCLORPHEN TABLET | PARACETAMOL | 300 mg |
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
42 | PEDILIX COUGH LINCTUS | PROMETHAZINE HCl | 1.5 mg/5 ml |
PHOLCODINE | 1.5 mg/5 ml | ||
PHENYLPROPANOLAMINE HCl | 10 mg/5 ml | ||
43 | PROFLU TABLET | PARACETAMOL | 300 mg |
CHLORPHENIRAMINE MALEATE | 1 mg | ||
PHENYLPROPANOLAMINE Hcl | 12.5 mg | ||
ASCORBIC ACID | 25 mg | ||
44 | RHINOPRONT SYRUP | PHENYLPROPANOLAMINE | 300 mg/90 ml |
CARBINOXAMINE | 24 mg/90 ml | ||
45 | ROBITUSSIN-CF SYRUP | GUAIPHENESIN | 100 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/ 5ml | ||
DEXTROMETHORPHAN HBr | 10 mg/5 ml | ||
46 | SINUZIN-D TABLETS | PARACETAMOL | 325 mg |
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
CHLORPHENIRAMINE MALEATE | 2 mg | ||
47 | SYNCOLDTAB-M TABLET | PHENYLPROPANOLAMINE HCl | 25 mg |
CHLORPHENIRAMINE MALEATE | 2 mg | ||
48 | TEMPRO SUSPENSION | PARACETAMOL | 250 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 10 mg/5 ml | ||
CHLORPHENIRAMINE MALEATE | 2 mg/5 ml | ||
49 | TRIPRO SYRUP | TRIPROLIDINE HCl | 1.25 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 12.5 mg/5 ml | ||
50 | UNIRHINOL FORTE TABLET | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 4 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
51 | UNIRHINOL TABLET | PARACETAMOL | 500 mg |
CHLORPHENIRAMINE MALEATE | 2 mg | ||
PHENYLPROPANOLAMINE HCl | 25 mg | ||
52 | UPHAMIN CAPSULE | PARACETAMOL | 250 mg |
CHLORPHENIRAMINE MALEATE | 2 mg | ||
PHENYLPROPANOLAMINE HCl | 12.5 mg | ||
53 | WALEKOF SYRUP | TRIMEPRAZINE TARTRATE | 2.5 mg/5 ml |
PHENYLPROPANOLAMINE HCl | 10 mg/5 ml | ||
GUAIPHENESIN | 25 mg/5 ml |
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