drugs

ratinacage SG

Claim: The drug Premarin is produced from the urine of pregnant horses.
Status: True.

Origins: One
of the inevitable aspects of the aging process in women is the decreased production of the hormones estrogen and progestin. A 40% to 60% drop-off in estrogen production generally occurs with the onset of menopause (or after some types of hysterectomies). Unfortunately, for many women these changes often are accompanied by uncomfortable symptoms (such as hot flashes, night sweats, and vaginal dryness), and estrogen loss is also linked to a significant increase in the incidence of heart disease, stroke, and osteoporosis.

Premarin (and Premarin-containing products such as Prempro, Premphase, and Prempac) is a drug used in hormone replace therapy HRT regimens prescribed for women to help lessen the symptoms of menopause and reduce the risk of heart disease, stroke, and osteoporosis. Premarin is available in several forms (pills, creams, injections, patches) and, as the name (a shortening of the phrase "pregnant mares' urine") suggests, contains conjugated estrogens obtained from the urine of pregnant mares.

Premarin is not unique as an animal-derived drug, of course, as generations of diabetics have been kept alive through injections of purified insulin obtained from the pancreases of cattle and pigs. No real alternative to animal insulin was available until 1982, when the U.S. Food and Drug Administration approved the first synthetic insulin, Humulin.

The continued use of Premarin has generated controversy because of issues associated with the industrial use of animals required to produce a supply of the drug; information regarding concerns over the "pee line" collection of urine from mares to produce Premarin is available on a number equine advocacy web sites. (Although cattle and pigs were used as sources of insulin for diabetics, those animals were not specifically raised to be insulin producers; the insulin was obtained from animals raised and slaughtered for the beef and pork markets.)

The development of generic alternatives (such as Estrace, Estraderm, Ogen, OrthoEst, Estratab, Menest, Estinyl, Estrovirus, and OrthoDienestrol) and synthetic estrogens (such as Cenestin) has been cited as an advancement that eliminates the need for animal-derived estrogens such as Premarin for most women.

ratinacage SG

IMMEDIATE ACTION REQUIRED!! The FDA has announced a recall of all drug products containing PPA (phenylpropanolamine). The AAFES stock assortment contains 23 products containing this drug (see below) .... ALL MUST BE PULLED FROM SALE IMMEDIATELY and placed in controlled storage pending disposition instructions. In addition, customers presenting unused quantities of these items purchased from AAFES may be given full refunds. Locally printed signs will be placed as follows:
CRC Description
----------------------------
5252333 ALKA-SELTZER PLUS
1350966 TAVIST-D
7388036 TRIAMINIC TRIAMINICOL
9175688 CONTACT SEVERE COLD 16 CT
1190814 COMTREX DEEP CHEST 24 CT
7533225 DEXATRIM XS W/VIT C
6400584 DEXATRIM EXT DURATION (PHASE-OUT STATUS)
3131711 ACCUTRIM MAXIMUM STRENGTH
1307750 DIMETAPP DM COUGH/COLD
3028438 DIMETAPP ELIXER
1216522 ALKA SELTZER PLUS COLD LIQUID
3709664 ALKA SELTZER PLUS NIGHT TIME (PHASE OUT STATUS)
5275920 ALKA SELTZER PLUS ORANGE
3782000 ALKA SELTZER PLUS TABS
3509700 ALKA SELTZER PLUS NIGHT TIME TABS
7730608 AAFES TUSSIN CF COUGH FORMULA 4 OZ.
8515727 AAFES DIMAPHEN ELIXIR 4 OZ.
8093916 AAFES EFFERVESCENT COLD RELIEF 36 COUNT
3024833 AAFES DIET CAPLETS
8147803 PERMATHENE-16
3247319 ROBITUSSIN CF COUGH SYRUP
3114808 COMTREX MULTI SYMPTOM
3377900 SINE OFF SINUS

This recall action is mandatory and should be accomplished as soon as possible. Report compliance to respective Region retail offices via TAO. Contact CARTERRE with questions.

Origins: On
6 November 2000, the U.S. Food and Drug Administration issued a warning that phenylpropanolamine, an ingredient found in many over-the-counter cold medications and diet aids, may cause strokes and thus should be avoided. Although the FDA did not issue a mandatory recall of PPA-containing products, they asked drug manufacturers to voluntarily stop selling products containing PPA and provide safer alternatives. As a result, most products that formerly included PPA have now been discontinued or reformulated without PPA while the FDA proceeds with the regulatory process necessary to remove all PPA-containing products from the market.

The list of products cited in the e-mail quoted above is two years out of date, and as the FDA has noted:

[T]here is no comprehensive, updated list available from FDA. FDA is aware of emails circulating widely that list many products allegedly containing PPA. Those emails are no longer valid and should be ignored. Please read the labels of OTC products to determine if they contain PPA.
The FDA is answering PPA questions toll-free at (88 Cool INFO-FDA. A direct line, although it is not toll-free, is (301) 827-4570. The FDA also has a Phenylpropanolamine (PPA) Information Page available on their web site. The FDA has advised that consumers go through their medicine cabinets, paying special attention to cold remedies and diet aids, and discard any medications that list phenylpropanolamine as one of their ingredients.

According to the FDA, "Although the risk of hemorrhagic stroke is very low, FDA recommends that consumers not use any products that contain PPA." The FDA warning came as a result of a May 2000 study conducted at Yale University School of Medicine, in which the Hemorrhagic Stroke Project found PPA to increase the risk of hemorrhagic stroke, a type of stroke characterized by bleeding in the brain. In October 2000, an FDA advisory committee confirmed the findings in the Yale study published by The New England Journal of Medicine, which suggested that PPA could raise the risk of stroke even in young people aged 18 to 49.

Not everyone is convinced that PPA poses nearly as much of a threat to consumers as claimed, and some critics have maintained the withdrawal was initiated by an overly cautious FDA based on flawed studies