Loperamide cases reported to United States poison centers, 2010–2022

Autor: Aaditya Patel, Natalie I. Rine, Henry A. Spiller, Hannah Hays, Jaahnavi Badeti, Motao Zhu, Kele Ding, Gary A. Smith
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Injury Epidemiology, Vol 10, Iss 1, Pp 1-13 (2023)
Druh dokumentu: article
ISSN: 2197-1714
DOI: 10.1186/s40621-023-00473-2
Popis: Abstract Background Intentional use of high doses of loperamide has been linked to serious cardiac toxicity. The objective of this study is to investigate the characteristics and trends of loperamide cases reported to United States (US) poison centers and to evaluate the changes in reported loperamide cases following US Food and Drug Administration (FDA) warnings, labeling requirements, and packaging restrictions for loperamide starting in 2016, with an emphasis on intentional exposures. Methods Data from the National Poison Data System were analyzed. Results There were 12,987 cases reported to US poison centers from 2010 to 2022, for which, loperamide was the most likely substance responsible for observed clinical effects. Although 46.1% of these cases were associated with minor or no effect, 13.4% resulted in a serious medical outcome, including 59 deaths (0.5%). Eight percent (8.1%) of cases were admitted to a critical care unit and 5.0% were admitted to a non-critical care unit. Among cases with a serious medical outcome, most were associated with loperamide abuse (38.0%), intentional-misuse (15.7%), or suspected suicide (27.5%). The majority (60.0%; n = 33) of fatalities were related to abuse, followed by suspected suicide (20.0%; n = 11) and intentional-misuse (5.5%, n = 3). The rate of loperamide cases per 100,000 US population reported to US PCs decreased from 0.44 in 2010 to 0.36 in 2015 (p = 0.0290), followed by an increase to 0.46 in 2017 (p = 0.0013), and then a trend reversal with a decrease to 0.28 in 2022 (p
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