Menthol overdose

Answer 1

Definition

Menthol is used as a flavoring agent for candy and other products. This article discusses menthol poisoning from swallowing pure menthol.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

Menthol

Where Found

Menthol may be found in:

• Breath fresheners
• Candy
• Cigarettes
• Cold soremedications
• Cough drops
• Creams and lotions to relieve itching
• Gum
• Inhalants, lozenges, or ointments to treat nasal congestion
• Medications to treat sore mouth, throat, or gums
• Mouthwashes
• Ointments to treat aches and pains (Ben-Gay, Therapeutic Mineral Ice)
• Peppermint oil

Note: This list may not include all uses of menthol.

Symptoms

• Bladder and kidneys
  • Blood in the urine
  • No urine output
• Lungs
  • Rapid breathing
  • Shallow breathing
• Gastrointestinal
  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting
• Heart and blood
  • Rapid heartbeat
• Nervous system
  • Convulsions
  • Dizziness
  • Tremor
  • Unconsciousness
  • Unsteady walking

Home Treatment

Seek immediate medical help. If the menthol is in ointment/cream form, wipe away any that has contacted the skin or eyes, and flush with water for several minutes. Call Poison Control for further guidance.

Before Calling Emergency

Determine the following information:

• The patient's age, weight, and condition
• The name of the product (ingredients and strengths, if known)
• Time it was swallowed
• Amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to expect at the emergency room

The health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:

• Activated charcoal
• Breathing support, including a breathing tube
• Endoscopy -- camera down the throat to see burns in the esophagus and the stomach
• Fluids through a vein (by IV)
• Medicines to treat the effects of the poison
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Expectations (prognosis)

How well you do depends on the amount of poison swallowed and how quickly medical treatment is received. The faster you get medical help, the better the chance for recovery.

Swallowing such poisons can have severe effects on many parts of the body.

However, pure menthol is not readily available. The menthol found in many over-the-counter products is usually watered down and mixed with other ingredients. Therefore, how well a patient does also depends on the other ingredients in the product.

References

Maypole J, Woolf AD, Donovan JW. Essential oils. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 101.

Answer 2

Definition

Menthol is used as a flavoring agent for candy and other products. This article discusses menthol poisoning from swallowing pure menthol.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

Menthol

Where Found

Menthol may be found in:

• Breath fresheners
• Candy
• Cigarettes
• Cold soremedications
• Cough drops
• Creams and lotions to relieve itching
• Gum
• Inhalants, lozenges, or ointments to treat nasal congestion
• Medications to treat sore mouth, throat, or gums
• Mouthwashes
• Ointments to treat aches and pains (Ben-Gay, Therapeutic Mineral Ice)
• Peppermint oil

Note: This list may not include all uses of menthol.

Symptoms

• Bladder and kidneys
  • Blood in the urine
  • No urine output
• Lungs
  • Rapid breathing
  • Shallow breathing
• Gastrointestinal
  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting
• Heart and blood
  • Rapid heartbeat
• Nervous system
  • Convulsions
  • Dizziness
  • Tremor
  • Unconsciousness
  • Unsteady walking

Home Treatment

Seek immediate medical help. If the menthol is in ointment/cream form, wipe away any that has contacted the skin or eyes, and flush with water for several minutes. Call poison control for further guidance.

Before Calling Emergency

Determine the following information:

• The patient's age, weight, and condition
• The name of the product (ingredients and strengths, if known)
• Time it was swallowed
• Amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to expect at the emergency room

The health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:

• Activated charcoal
• Breathing support, including a breathing tube
• Tube down the windpipe and lungs to look for damage and burns (bronchoscopy)
• Fluids through a vein (by IV)
• Medicines to treat the effects of the poison
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Expectations (prognosis)

How well you do depends on the amount of poison swallowed and how quickly medical treatment is received. The faster you get medical help, the better the chance for recovery.

Swallowing such poisons can have severe effects on many parts of the body.

However, pure menthol is not readily available. The menthol found in many over-the-counter products is usually watered down and mixed with other ingredients. Therefore, how well a patient does also depends on the other ingredients in the product.

References

Maypole J, Woolf AD, Donovan JW. Essential oils. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 101.

Nair B. Final report on the safety assessment of Mentha Piperita (Peppermint) Oil, Mentha Piperita (Peppermint) Leaf Extract, Mentha Piperita (Peppermint) Leaf, and Mentha Piperita (Peppermint) Leaf Water.Int J Toxicol. 2001;20 Suppl 3:61-73.

Reviewed By

Review Date: 02/16/2012

Eric Perez, MD, St. Luke's / Roosevelt Hospital Center, NY, NY, and Pegasus Emergency Group (Meadowlands and Hunterdon Medical Centers), NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.