Five cases of fatal overdose from caffeine-containing "look-alike" drugs

Five cases of death from ingestion of "look-alike" dose forms are reported. "Look-alikes" are widely used non-prescription drugs sold as appetite suppressants or stimulants. Three of the cases had taken caffeine/ephedrine combinations, and two had taken caffeine only. All had lethal concentrations of caffeine detected in the blood (130 to 344 mg/L), and three had high ephedrine concentrations from 3.5 to 20.5 mg/L. Caffeine and ephedrine were measured in body fluids and tissues (when available) by SIM gas chromatography/mass spectrometry (GC/MS) after extraction with diethyl ether.