Yes

Alpha/Beta Agonist

Anorexiant; nasal decongestant

C

Known hypersensitivity to drug

Use with caution in patients with high blood pressure, tachyarrhythmias, pheochromocytoma, bradycardia, cardiac disease, arteriosclerosis; do not use for more than 3 weeks for weight loss

>10%: Cardiovascular: Hypertension, palpitations

1% to 10%:

Central nervous system: Insomnia, restlessness, dizziness

Gastrointestinal: Xerostomia, nausea

<1%: Tightness in chest, bradycardia, arrhythmias, angina, severe headache, anxiety, nervousness, restlessness, dysuria

Symptoms of overdose include vomiting, hypertension, palpitations, paresthesia, excitation, seizures

Treatment is supportive; diazepam 5-10 mg I.V. (0.25-0.4 mg/kg for children) may be used for excitation and seizures

Decreased effect of antihypertensives

Increased effect/toxicity with MAO inhibitors (hypertensive crisis), beta-blockers (increased pressor effects)

Releases tissue stores of epinephrine and thereby produces an alpha- and beta-adrenergic stimulation; this causes vasoconstriction and nasal mucosa blanching; also appears to depress central appetite centers

Duration: Up to 24 hours (timed release)

Absorption: Oral: Well absorbed

Metabolism: In the liver to norephedrine

Bioavailability: Close to 100%

Half-life: 4.6-6.6 hours

Elimination: In urine primarily as unchanged drug (80% to 90%)

Oral:

2-6 years: 6.25 mg every 4 hours

6-12 years: 12.5 mg every 4 hours not to exceed 75 mg/day

Adults:

Decongestant: 25 mg every 4 hours or 50 mg every 8 hours, not to exceed 150 mg/day

Anorexic: 25 mg 3 times/day 30 minutes before meals or 75 mg (timed release) once daily in the morning

Precision release: 75 mg after breakfast

Should be administered 30 minutes before meals

Blood pressure, heart rate

May cause dizziness, restlessness, anxiety, or insomnia

Concurrent use with MAOIs may result in hypertensive crisis; avoid combination

Use with caution since phenylpropanolamine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response

Up to 10% of patients could experience tachycardia, palpitations, and dry mouth; use vasoconstrictor with caution

Nasal decongestant: Do not use for longer than recommended (4-5 days in a row). Anorexiant: Do not use for longer than 3 weeks. With timed release form, take early in day; do not chew or crush. Do not use more often, or in greater dose than prescribed. You may experience dizziness or blurred vision (use caution when driving or engaging in tasks requiring alertness until response to drug is known). With nasal use you may experience burning or stinging (this will resolve). Report rapid heartbeat, chest pain, palpitations; persistent vomiting; excessive nervousness, trembling, or insomnia; difficult or painful urination; unresolved burning or stinging (eyes or nose); or acute headache. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Administer dose early in day to prevent insomnia; observe for signs of nervousness, excitability

Capsule, as hydrochloride: 37.5 mg

Capsule, as hydrochloride, timed release: 25 mg, 75 mg

Tablet, as hydrochloride: 25 mg, 50 mg

Tablet, as hydrochloride:

Precision release: 75 mg

Timed release: 75 mg

Bernstein E and Diskant BM, "Phenylpropanolamine: A Potentially Hazardous Drug," Ann Emerg Med, 1982, 11(6):311-5.

Elkins B and Spoerke DG, "An Estimation of the Toxicity of Nonprescription Diet Aids From Seventy Exposure Cases," Vet Hum Toxicol, 1983, 25:81-5.

Forman HP, Levin S, Stewart B, et al, "Cerebral Vasculitis and Hemorrhage in an Adolescent Taking Diet Pills Containing Phenylpropanolamine: Case Report and Review of Literature," Pediatrics, 1989, 83(5):737-41.

Pentel P, "Toxicity of Over-the-Counter Stimulants," JAMA, 1984, 252(14):1898-903.

Puder KS and Morgan JP, "Persuading by Citation: An Analysis of the References of Fifty-Three Published Reports of Phenylpropanolamine's Clinical Toxicity," Clin Pharmacol Ther, 1987, 42(1):1-9.

Romanowski GL, Shimp LA, Balson AB, et al, "Urinary Incontinence in the Elderly: Etiology and Treatment," Drug Intell Clin Pharm, 1988, 22(7-8):525-33.