The Safety of Phenylpropanolamine in Patients with Stable Hypertension
Authors: Kurt Kroenke
Journal: Annals of Internal Medicine (1989)

Brief Reports15 December 1989The Safety of Phenylpropanolamine in Patients with Stable HypertensionKurt Kroenke, MD, LTC, MC, Deborah M. Omori, MD, MAJ, MC, John O. Simmons, MD, MAJ, MC, David R. Wood, DO, Nancy J. Meier, RNKurt Kroenke, MD, LTC, MC, Deborah M. Omori, MD, MAJ, MC, John O. Simmons, MD, MAJ, MC, David R. Wood, DO, Nancy J. Meier, RNAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-12-1043 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPhenylpropanolamine is a popular decongestant and appetite suppressant, with an estimated 5 billion doses consumed annually (1). However, label directions still caution people with hypertension against using products containing phenylpropanolamine. Isolated reports of complications have often involved either phenylpropanolamine overdoses or a more potent isomeric form unavailable in the United States (1-3). Given the prevalence of hypertension and the wide availability of phenylpropanolamine, the rare occurrence of hypertensive events in persons taking phenylpropanolamine is just as likely coincidental as causative. The purported risks of phenylpropanolamine remain debatable (4, 5). Numerous clinical trials have shown the safety of phenylpropanolamine in normotensive...References1. Morgan J. Phenylpropanolamine: A Critical Analysis of Reported Adverse Reactions and Overdosage. Fort Lee, New Jersey: Jack K. Burgess; 1986. Google Scholar2. Morgan J, Kagan D, and Brody J, eds. Phenylpropanolamine: Risks, Benefits, and Controversies. New York: Praeger; 1985. Google Scholar3. Lasagna L. Phenylpropanolamine-A Review. New York: John Wiley & Sons; 1988. Google Scholar4. Radack K and Deck C. Are oral decongestants safe in hypertension? An evaluation of the evidence and a framework for assessing clinical trials. Ann Allergy. 1986;56:396-401. MedlineGoogle Scholar5. Puder K and Morgan J. Persuading by citation: an analysis of the references of fifty-three published reports of phenylpropanolamine's clinical toxicity. Clin Pharmacol Ther. 1987;42:1-9. CrossrefMedlineGoogle Scholar6. Goodman R, Wright J, Barlascini C, McKenney J, and Lambert C. The effect of phenylpropanolamine on ambulatory blood pressure. Clin Pharmacol Ther. 1986;40:144-7. CrossrefMedlineGoogle Scholar7. Saltzman M, Dolan M, and Doyne N. Comparison of effects of two dosage regimens of phenylpropanolamine on blood pressure and plasma levels in normal subjects under steady-state conditions. Drug Intell Clin Pharm. 1983;17:746-50. CrossrefMedlineGoogle Scholar8. Blackburn G, Morgan J, Lavin P, Noble R, Funderburk F, and Istfan N. Determinants of the pressor effect of phenylpropanolamine in healthy subjects. JAMA. 1989;261:3267-72. CrossrefMedlineGoogle Scholar9. Liebson I, Bigelow G, Griffiths R, and Funderburk F. Phenylpropanolamine: effects on subjective and cardiovascular variables at recommended over-the-counter dose levels. J Clin Pharmacol. 1987;27:685-93. CrossrefMedlineGoogle Scholar10. Unger D, Unger L, and Temple D. Effect of an anti-asthmatic compound on blood pressure of hypertensive asthmatic patients. Ann Allergy. 1967;25:260-1. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Kurt Kroenke, MD, LTC, MC; Deborah M. Omori, MD, MAJ, MC; John O. Simmons, MD, MAJ, MC; David R. Wood, DO; Nancy J. Meier, RNFrom the Uniformed Services University of the Health Sciences, Bethesda, Maryland; and Brooke Army Medical Center, San Antonio, Texas. For current author addresses, see end of text. 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