The evidence of a link between haemorrhagic stroke and phenylpropanolamine is weak and mainly associated with uses that are not licensed in the United Kingdom, the Committee on Safety of Medicines concluded last week. The CSM will carry out further detailed evaluation of the use of the drug in the UK over the next two weeks and will meet again on November 22 to discuss the findings. In the meantime, a letter from the CSM has been sent to all pharmacists and general practitioners alerting them to the current situation. The letter notes that patients should be reminded that products should be used as stated on the label and that the maximum daily dose of 100mg phenylpropanolamine should not be exceeded. Patients with high blood pressure, hyperthyroidism or heart disease and those receiving monoamine oxidase inhibitors should not take phenylpropanolamine. In addition, the drug might aggravate conditions such as diabetes, glaucoma and prostatic enlargement, the letter states.