RT Book, Section A1 Benowitz, Neal L. A2 Olson, Kent R. A2 Anderson, Ilene B. A2 Benowitz, Neal L. A2 Blanc, Paul D. A2 Clark, Richard F. A2 Kearney, Thomas E. A2 Kim-Katz, Susan Y. A2 Wu, Alan H. B. SR Print(0) ID 1174606896 T1 PSEUDOEPHEDRINE, PHENYLEPHRINE, AND OTHER DECONGESTANTS T2 Poisoning & Drug Overdose, 7e YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9780071839792 LK accessmedicine.mhmedical.com/content.aspx?aid=1174606896 RD 2024/10/08 AB Pseudoephedrine and phenylephrine are sympathomimetic drugs that are widely available in nonprescription nasal decongestants and cold preparations. These remedies usually also contain antihistamines and cough suppressants. Nonprescription ephedrine-containing cough and cold preparations as well as ephedrine-containing dietary supplements were widely consumed until 2004, when their use was banned by the FDA because of the unacceptable risk for toxicity. Ephedrine and ephedra-containing herbal preparations (eg, ma huang and "herbal ecstasy"), often in combination with caffeine, were also used as alternatives to the amphetamine derivative "ecstasy" or as adjuncts to body-building or weight loss programs. Phenylpropanolamine (PPA) had been marketed as a nonprescription decongestant and appetite suppressant for many years but was removed from the US market in 2000 because of an association with hemorrhagic stroke in women. The availability of nonprescription pseudoephedrine is limited in many states because it can be used to manufacture illicit methamphetamine. The FDA issued an advisory in 2008 recommending against the use of cough and cold medicines (which contain decongestants as well as antihistamines and/or dextromethorphan) to children younger than 2 years of age because of reports of serious and life-threatening side effects.