DOH warns vs cold medicines

Health Secretary Alberto Romualdez advised the public yesterday to refrain from taking over-the-counter cough and cold remedies because some of these drugs may actually inflict more damage than a plain runny nose.

He said some cold pills and diet tablets contain phynylpropanoloamine (PPA), which studies abroad have linked to the increased incidence of hemorrhagic stroke.

"So far, there is no reported case of hemorrhagic stroke following the use of PPA in cough and cold pre-parations, while appetite suppressants containing PPA are not available in the country," Romualdez said.

He added that those with hypertension are more susceptible to the ill effects of PPA.

No appetite suppressants or diet pills containing PPA have been registered with the Bureau of Food and Drugs (BFAD), he said, but it is possible that some people may be secretly bringing it in from abroad.

A drug information study published in the New England Journal of Medicine disclosed that women taking PPA-laced appetite suppressants are 16 times more likely to have hemorrhagic stroke or cerebral hemorrhage.

Although the study was not able to calculate the rate of risk for men because no males in the study took the diet pills, it cannot be concluded that men face a lower risk.

This prompted the US Food and Drug Administration (FDA) to delist the drug from the market and, in some cases, recommend pseudoephedrine as a substitute.

But Romualdez said pseudoephedrine is a controlled and highly regulated drug here because it can cause various ills ranging from seizures to heart ailments, and can lead to the use of illegal drugs shabu and Ecstasy.

The highest dose of PPA in cold remedies is 50 mg. while the median dose is 75 to 150 mg. in diet pills. A dose of at least 75 mg. is considered a health hazard.

The BFAD, which is under the health department, is convening a public hearing with the National Drug Committee and the manufacturers of cough and cold remedies to look further into the matter.

Among the issues to be discussed are alternative cold remedies available in the market, the recommendation that PPA be classified into a prescription drug, and the possibility of replacing PPA with another compound but not pseudoephedrine.

Romualdez explained that PPA is a blood vessel-constrictor and may cause high blood pressure. But in the case of cold remedies, he said it only acts to shrink swollen or dilated mucus membranes, leading to decongestion.

He also recommended that enough rest or sleep and plenty of fluids were best for colds. "There is no real cure for colds because this viral illness is self-limited. So it just goes away without medication provided that one takes a lot of rest and fluids," he added.

Meanwhile, multinational drug companies have finally made good their threat to take legal action against the Philippine government for its plan to continue importing branded pharmaceutical products from India.

In a motion for temporary restraining order (TRO), the Pharmaceutical and Healthcare Association of the Philippines (PHAP) sought relief from the Makati Regional Trial Court, saying that government’s parallel importation policy constituted unfair trade practice and violated trademark laws and patent rights.

PHAP, a group of about 80 multinational companies that manufacture or sell branded drugs in the country, has been at loggerheads with the government over the huge price discrepancy between drugs sold here and those sold in other Asian countries.

Drugs sold in other parts of the region are generally cheaper than the same ones sold here.

The TRO is expected to derail government’s plan to import a second, bigger batch of critical branded drugs from India for distribution to a wider range of public hospitals nationwide, following the success of its first importation.

The Department of Trade and Industry and the Department of Health launched the program this year, importing lower priced drugs and selling these through government hospitals rather than the identical but costlier products produced by the same companies based in the Philippines.

It was noted that in many cases, the drugs sold here by the multinationals were 10 times more expensive than identical brands sold in India and other Asian countries.

Romualdez said he was appalled by the PHAP’s move, adding the TRO plea was "clear evidence that these companies place their profits and financial gain higher in their scale of values than the health of Filipinos."

But the DTI had been expecting aggressive opposition to its parallel importation, from law suits to the possible release of fake products to sabotage the program.

A generics drug law had been passed to help make vital drugs accessible to public. – With Des Ferriols