The U.S. Food and Drug Administration (FDA) is calling on the manufacturers of inhalers that contain the nasal decongestant propylhexedrine to make design changes to prevent misuse, HealthDay reports. It is sold over the counter under the brand name Benzedrex.

“Benzedrex inhalers can be legally purchased, but propylhexedrine abuse occurs as people try to find legal ways to get high or increase productivity and concentration,” according to the National Capital Poison Center.

The FDA says the abuse and misuse of the decongestant can lead to complications including fast or abnormal heart rhythm, high blood pressure and paranoia. These complications can lead to hospitalization, disability or death.

“Reports of individuals abusing and misusing propylhexedrine have increased in recent years,” the FDA noted in a statement.

Propylhexedrine is safe and effective when used as directed, the agency said.

Modifying the inhaler to create a physical barrier that would make tampering with the device and abusing the propylhexedrine inside more difficult, the FDA said. In addition, decreasing the amount of medicine the device contains could also reduce the risk of serious side effects if abused or misused, the agency said.