There is a new hazard in over-the-counter medication. Apparently, drug companies can change the ingredients of a brand name product without any notice to the consumer. Until recently, Anusol suppositories (Warner-Lambert, Morris Plains, New Jersey) contained bismuth subgallate, bismuth resorcin, and pramoxine hydrochloride, a local anesthetic, in a base of zinc oxide and coconut oil.

Now labeled identically except for the very fine print, Anusol is totally different, containing phenylephrine (0.25%), hard fat (88.7%), cornstarch, methylparaben, and propylparaben; it no longer contains bismuth. Phenylephrine is a sympathomimetic drug. It is contraindicated for patients receiving monoamine oxidase inhibitors or suffering from hypertension. The label now warns against use if "taking a prescription drug for high blood pressure or depression without first consulting your doctor". How many patients and doctors who have used or prescribed this medication routinely are aware of this new formulation?

It should be against the Food and Drug Administration (FDA) regulations for manufacturers to change the ingredients of brand name drugs without changing the brand name.