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Severe toxicity after use of 2,4-dinitrophenol reported to the UK National Poisons Information Service



Author/s Kamour A, Gwynnette D, George N, Cooper G, Lupton DJ, Eddleston M, Thompson JP, Vale JA, Thanacoody RHK, Hill S, Thomas SHL
Year 2014
Type of publication Conference proceeding
Link https://doi.org/10.3109/15563650.2014.906213
Abstract

Background: 2,4-Dinitrophenol (DNP) was introduced as a weight-losing drug in the United States during the 1930s but was banned as a result of serious adverse effects and fatalities. DNP use has increased in popularity worldwide recently as an aid to weight loss, but severe toxicity and fatalities have been reported.

Objective: This study was performed to characterize the toxicity of DNP reported to the UK National Poisons Information Service (NPIS).

Methods: NPIS telephone enquiry records and user sessions for TOXBASE®, the NPIS online information database, involving systemic exposures to DNP were reviewed for the period January 1, 2007 to August 15, 2013.

Results: Of 23 exposures (20 males, 3 females; median age, 24 years) reported by telephone, there were 3 during 2007–2011, 5 during 2012, and 15 during 2013 (to August 15th). TOXBASE® user sessions also increased sharply from 6 in 2011 to 35 in 2012 and 127 in 2013. Exposure was reported as chronic (n = 15), acute (n = 6), acute on chronic (n = 1), and unknown (n = 1). Commonly reported features were fever (61%), tachycardia (57%), sweating (39%), skin discoloration or rash (35%), nausea or vomiting (22%), abdominal pain (17%), and headache (17%). Agitation, metabolic acidosis, and chest pain were each reported in 13% of cases. There were five (22%; 95% confidence intervals 8%, 44%) fatalities, three involving acute exposure.

Conclusion: There has been a recent increase in DNP exposures reported to the NPIS by telephone and in accesses to TOXBASE®, with a high mortality. Measures to improve public awareness are needed to warn potential users of the severe and sometimes fatal toxicity that may occur.

References

  • Tainter ML, Stockton AB, Cutting WC. Dinitrophenol in the treatment of obesity: Final report. JAMA 1935; 105:332–7.
  • Agency for Toxic Substances and Disease Registry. Toxicological Profile for Dinitrophenol. 1995.  
  • AuthenticSteroids. DNP (2,4-Dinitrophenol). 
  • Grundlingh J, Dargan P, El-Zanfaly M, et al. 2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death. J Med Toxicol 2011; 7:205–12. 
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