Dear Friends, Aku dapat informasi sebagai berikut dibawah ini, mengenai obat flu yg dikabarkan mengandung suatu zat yg mengakibatkan stroke. Adakah rekan-rekan yg mengetahui kebenarannya, krn dari daftar yg ada obat flu tsb sering kita gunakan. Terima kasih, Nova ---------------------------------------------------------------------------- -------------------------------------------- NATIONAL PHARMACEUTICAL ADMINISTRATION Ministry of Health 2 Jalan Bukit Merah Singapore 169547 http://www.gov.sg/moh/npa/index.html HEALTHCARE PROFESSIONAL CIRCULAR NO.1/2000 14 November 2000 Dear Health Care Professional WITHDRAWAL OF PHENYLPROPANOLAMINE (PPA) PRODUCTS 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. Phenylpropanolamine (PPA) is a sympathomimetic agent, commonly found in cough, cold and allergy medications. It is classified as a Pharmacy Medicine in Singapore. In the United States, PPA is popular as an over-the-counter cough and cold medicine as well as a slimming agent. Case reports have linked exposure to PPA to the occurrence of haemorrhagic stroke. Many of the affected patients have been young women using PPA as an appetite suppressant, often after a first dose. To further examine the association between PPA and haemorrhagic stroke, the Yale University Medical School designed a case-control study involving men and women ages 18 to 49 years who were hospitalised with a subarachnoid haemorrhage (SAH) or intracerebral haemorrhage (ICH). Eligible case subjects had no prior history of stroke and were able to participate in an interview within 30 days of their event. Case subjects were recruited from hospitals in 4 geographic regions of the United States. The final study cohort comprised 702 case subjects who were matched by demographic characteristics with 1,367 controls who had not had strokes. Age matching was successful for 1,367 controls (99%) and ethnicity matching was achieved for 1,321 controls (96%). For the association between haemorrhagic stroke and any use of PPA within 3 days, the adjusted odds ratio was 1.49 (lower limit of the one-sided 95% confidence interval (LCL) = 0.93, p = 0.084). For the association between haemorrhagic stroke and PPA use in cough/cold remedies within the 3-day exposure window, the adjusted odds ratio was 1.23 (LCL = 0.75, p = 0.245). For the association between haemorrhagic stroke and PPA use in appetite suppressants within the 3-day exposure window, the adjusted odds ratio was 15.92 (LCL = 2.04, p = 0.013). For the association between PPA in appetite suppressants and risk for haemorrhagic stroke among women, the adjusted odds ratio was 16.58 (LCL = 2.22, p = 0.011). For first dose PPA uses among women, the adjusted odds ratio was 3.13 (LCL = 1.05, p = 0.042). All first dose PPA use involved cough/cold remedies. - 2 - In conclusion, the results of the HSP suggest that PPA increases the risk for haemorrhagic stroke. The HSP is a case control study and there are limitations for definitive conclusions. However, the overall assessment was that the study was well-designed and executed. All reasonable steps were taken to minimise bias and confounding. The Ministry has also considered the HSP report in the context of the spontaneous reports of haemorrhagic stroke received by the US FDA during the period 1991 - 2000. Although the risk of haemorrhagic stroke is very low, the Ministry has significant concerns because of the seriousness of this adverse event (the irreversible outcome) and the inability to predict who is at risk. The Ministry does not consider the conditions for which PPA is used as justifying the risk of this serious event as alternative cough and cold medications which do not contain PPA are available for use. All doctors and pharmacists are advised not to prescribe or sell PPA-containing medications to patients. Please also reassure your patients 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 also do not have to be worried about their health as there are no long term adverse effects from PPA-containing products. The list of PPA-containing cough and cold remedies available in Singapore is enclosed at Annex. If you need further clarification, please contact Ms Chan Cheng Leng, Head (Information & Research) Unit, National Pharmaceutical Administration, at telephone 3255610 Yours sincerely DR JOHN LIM DIRECTOR NATIONAL PHARMACEUTICAL ADMINISTRATION MINISTRY OF HEALTH cc: President, SMA President, PSS Master, Academy of Medicine Annex Combination Products Containing PPA in Singapore S/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 TABLET 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 S/No. Name of Product Active Ingredients Strength 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 S/No. Name of Product Active Ingredients Strength 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 S/No. Name of Product Active Ingredients Strength 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 Category * Appetite suppressant * decongestant, nasal (systemic) * sympathomimetic (adrenergic) agent Description Phenylpropanolamine (fen-ill-proe-pa-NOLE-a-meen) , commonly known as PPA, is used as a nasal decongestant or as an appetite suppressant. It acts on many different parts of the body. PPA produces effects that may be helpful or harmful. This depends on a patient's individual condition and response and the amount of medicine taken. Phenylpropanolamine clears nasal congestion (stuffy nose) by narrowing or constricting the blood vessels. However, this same action may cause an increase in blood pressure in patients who have hypertension (high blood pressure). Phenylpropanolamine also decreases appetite. However, the way PPA and similar medicines do this is unclear. Stimulation of the central nervous system (CNS) may be a major reason. Phenylpropanolamine in combination with dieting, exercise, and changes in eating habits can help obese patients lose weight. However, this appetite-reducing effect is only temporary, and is useful only for the first few weeks of dieting until new eating habits are established. Phenylpropanolamine has caused serious side effects (even death) when too much was taken. There are a number of products on the market that contain only phenylpropanolamine. Other products contain PPA along with added ingredients. The information that follows is for PPA alone. There may be additional information for the combination products. Read the label of the product you are using. If you have questions or if you want more information about the other ingredients, check with your health care professional. Some preparations containing PPA are available only with your doctor's prescription. Others are available without a prescription; however, your doctor may have special instructions on the proper use of this medicine. Phenylpropanolamine is available in the following dosage forms: Oral * Capsules (U.S.) * Extended-release capsules (U.S.) * Tablets (U.S.) * Extended-release tablets (U.S.) Before Using This Medicine If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For phenylpropanolamine, the following should be considered: Allergies--Tell your doctor if you have ever had any unusual or allergic reaction to phenylpropanolamine or to amphetamine, dextroamphetamine, ephedrine, epinephrine, isoproterenol, metaproterenol, methamphetamine, norepinephrine, phenylephrine, pseudoephedrine, or terbutaline. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Pregnancy--Phenylpropanolamine has not been shown to cause birth defects in humans. However, women who take phenylpropanolamine in the weeks following delivery may be more likely to suffer mental or mood changes. Breast-feeding--Phenylpropanolamine has not been reported to cause problems in nursing babies. Children--Mental changes may be more likely to occur in young children taking phenylpropanolamine than in adults. Phenylpropanolamine should not be used for weight control in children under the age of 12 years. Children 12 to 18 years old should not take phenylpropanolamine for weight control unless its use is ordered and supervised by a doctor. Older adults--Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of phenylpropanolamine in the elderly with use in other age groups. Other medicines--Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking phenylpropanolamine, it is especially important that your health care professional know if you are taking any of the following: * Amantadine (e.g., Symmetrel) or * Amphetamines or * Caffeine (e.g., NoDoz) or * Chlophedianol (e.g., Ulone) or * Cocaine or * Medicine for asthma or other breathing problems or * Methylphenidate (e.g., Ritalin) or * Nabilone (e.g., Cesamet) or * Other appetite suppressants (diet pills) or * Other medicine for colds, sinus problems, or hay fever or other allergies (including nose drops or sprays) or * Pemoline (e.g., Cylert)--Using these medicines while taking phenylpropanolamine may cause severe nervousness, irritability, trouble in sleeping, or possibly irregular heartbeat or seizures * Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren])--Taking these medicines with phenylpropanolamine may cause serious high blood pressure (hypertension) and other effects on the heart * Digitalis glycosides (heart medicine)--Changes in the rhythm of your heart may occur * Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])--Taking phenylpropanolamine while you are taking or within 2 weeks of taking MAO inhibitors may cause sudden high body temperature, extremely high blood pressure, and severe convulsions; at least 14 days should be allowed between stopping treatment with one medicine and starting treatment with the other * Rauwolfia alkaloids (alseroxylon [e.g., Rauwiloid], deserpidine [e.g., Harmonyl], rauwolfia serpentina [e.g., Raudixin], reserpine [e.g., Serpasil])--Phenylpropanolamine may not work properly when taken with rauwolfia alkaloids Other medical problems--The presence of other medical problems may affect the use of phenylpropanolamine. Make sure you tell your doctor if you have any other medical problems, especially: * Diabetes mellitus (sugar diabetes)--Use of phenylpropanolamine may cause an increase in blood glucose levels * Enlarged prostate or * Glaucoma or * High blood pressure--Use of phenylpropanolamine may make the condition worse * Heart disease or blood vessel disease (including a history of heart attack or stroke) or * Overactive thyroid--Serious effects on the heart may occur * Mental illness, history of--Use of phenylpropanolamine may cause the mental illness to return Proper Use of This Medicine For patients taking an extended-release form of this medicine: * Swallow the capsule or tablet whole. Do not crush, break, or chew before swallowing. * Take with a full glass (at least 8 ounces) of water. * If taking only one dose of this medicine a day, take it in the morning around 10 a.m. Take phenylpropanolamine (PPA) only as directed . Do not take more of it, do not take it more often, and do not take it for a longer time than directed. To do so may increase the chance of side effects. For patients taking this medicine as an appetite suppressant : * Do not take this medicine for longer than a few weeks without your doctor's permission . If PPA causes trouble in sleeping, take the last dose for each day a few hours before bedtime. Dosing--The dose of phenylpropanolamine will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of phenylpropanolamine. If your dose is different, do not change it unless your doctor tells you to do so. The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking phenylpropanolamine . * For appetite control: * For oral dosage forms (capsules and tablets): * Adults--25 mg three times a day. Do not take more than 75 mg in twenty-four hours. * Children 12 to 18 years of age--Use and dose must be determined by your doctor. * Children up to 12 years of age--Use is not recommended. * For long-acting dosage forms (extended-release capsules and tablets): * Adults--75 mg taken once a day in the morning around 10 a.m. * Children 12 to 18 years of age--Use and dose must be determined by your doctor. * Children up to 12 years of age--Use is not recommended. * For stuffy nose: * For oral dosage forms (capsules and tablets): * Adults and children 12 to 18 years of age--25 mg every four hours as needed. Do not take more than 150 mg in twenty-four hours. * Children 6 to 12 years of age--12.5 mg every four hours as needed. Do not take more than 75 mg in twenty-four hours. * Children 2 to 6 years of age--6.25 mg every four hours as needed. Do not take more than 37.5 mg in twenty-four hours. * Children up to 2 years of age--Use and dose must be determined by your doctor. * For long-acting dosage forms (extended-release capsules and tablets): * Adults--75 mg every twelve hours. * Children--Use and dose must be determined by your doctor. Missed dose--For patients taking phenylpropanolamine for nasal congestion : If you miss a dose, take it as soon as possible. However, if it is within 2 hours (or 12 hours for extended-release forms) of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage--To store this medicine * Keep out of the reach of children. * Store away from heat and direct light. * Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. * Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children. Precautions While Using This Medicine Do not drink large amounts of caffeine-containing beverages, such as coffee, tea, or colas while you are taking this medicine. To do so may cause unwanted effects. This medicine may cause some people to become dizzy. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert . For patients taking this medicine for nasal congestion : * If cold symptoms do not improve within 7 days or if you also have a high fever, check with your doctor . These signs may mean that you have other medical problems. Side Effects of This Medicine Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor as soon as possible if any of the following side effects occur: Rare Headache (severe); increased blood pressure; painful or difficult urination; tightness in chest Early symptoms of overdose Abdominal or stomach pain; fast, pounding, or irregular heartbeat; headache (severe); increased sweating not caused by exercise; nausea and vomiting (severe); nervousness (severe); restlessness (severe) Late symptoms of overdose Confusion; convulsions (seizures); fast breathing; fast and irregular pulse; hallucinations (seeing, hearing, or feeling things that are not there); hostile behavior; muscle trembling Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome: Less common--more common with high doses Dizziness; dryness of nose or mouth; false sense of well-being; headache (mild); nausea (mild); nervousness (mild); restlessness (mild); trouble in sleeping Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. Additional Information Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, phenylpropanolamine is used in certain patients with the following medical condition: * Urinary stress incontinence (loss of bladder control when you cough, sneeze, or laugh) Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use. Revised: 12/09/98 >>>> 2.5 Mbps InternetShop >> InternetZone << Margonda Raya 340 <<<< >> Kirim bunga ke-20 kota di Indonesia? Klik, http://www.indokado.com >> Info balita, http://www.balita-anda.indoglobal.com Etika berinternet, email ke: [EMAIL PROTECTED] Stop berlangganan, e-mail ke: [EMAIL PROTECTED]
