Intoxication with Over-the-Counter Antitussive Medication Containing Dihydrocodeine and Chlorpheniramine Causes Generalized Convulsion and Mixed Acidosis

We report a 35-year-old man who was referred to our hospital with generalized convulsion and mixed acidosis presumably caused by abuse of SS-BRONTM tablets, an over-the-counter (OTC) antitussive medication sold in Japan. These tablets contain dihydrocodeine phosphate, methylephedrine, chlorphenirami...

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Bibliographic Details
Published inInternal Medicine Vol. 47; no. 11; pp. 1013 - 1015
Main Authors Murao, Satoshi, Manabe, Hiroaki, Yamashita, Tetsuji, Sekikawa, Takashi
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2008
Subjects
acidosis
Acidosis - chemically induced
Adult
antitussive
Antitussive Agents - toxicity
chlorpheniramine
Chlorpheniramine - toxicity
codeine
Codeine - analogs & derivatives
Codeine - toxicity
convulsion
Ephedrine - analogs & derivatives
Ephedrine - toxicity
Humans
Japan
Male
Nonprescription Drugs - toxicity
Seizures - chemically induced
Substance-Related Disorders - complications
Japan
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Summary:We report a 35-year-old man who was referred to our hospital with generalized convulsion and mixed acidosis presumably caused by abuse of SS-BRONTM tablets, an over-the-counter (OTC) antitussive medication sold in Japan. These tablets contain dihydrocodeine phosphate, methylephedrine, chlorpheniramine, and caffeine. Although it is difficult to discern which component caused these symptoms, it seems that dihydrocodeine phosphate or methylephedrine was involved in the addiction to SS-BRONTM and chlorpheniramine may have caused the generalized convulsion. It should be recognized that an OTC antitussive, which is quite easy to obtain, can be abused and subsequently induce serious intoxication.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.47.0925