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Movement Away From Phenolphthalein in Laxatives
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To the Editor: In the enjoyable JAMA Classics discussion by Dr Evens1 regarding the 1924 article describing roentgenologic examination of the gallbladder, I spotted 1 factual error. Evens mentioned that the contrast agent used by Graham and Cole in the original study, phenolphthalein, is still marketed today under the brand name of ex-lax. Phenolphthalein was formally banned by the Food and Drug Administration as an ingredient in over-the-counter laxatives in 1999 due to concerns of possible carcinogenicity.2 Products containing phenolphthalein, including ex-lax, were reformulated in 1997 in anticipation of the ban; the active ingredient in ex-lax is now senna.
Financial Disclosures: None reported.
James Murphy, RPh
james@prnnewsletter.com
PRN Publishing
Forest Hills, New York
1. Evens RG. Roentgenologic examination of the gallbladder (cholecystography): the article that launched a new era of radiology. JAMA. 2009;301(1):100-101.
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2. Federal Register volume 64, No. 19; Friday, January 29, 1999; Rules and Regulations 4535-4540. http://www.fda.gov/OHRMS/DOCKETS/98fr/012999b.pdf. Accessed March 3, 2009.
Letters Section Editor: Robert M. Golub, MD, Senior Editor.
JAMA. 2009;301(17):1770.
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Roentgenologic Examination of the Gallbladder (Cholecystography): The Article That Launched a New Era of Radiology
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