MT-45: A Synthetic Opioid With an Unusual Adverse Effect Profile

The opioid crisis continues to be a problem in the United States. The rise of illicit synthetic opioids continues to be a threat to those that may unknowingly digest these substances. Herein, we present a synthetic opioid, MT-45, that has an unusual adverse effect profile. In one case series, three patients experienced ototoxicity. In a separate case series, three patients experienced a range of symptoms that included visual impairment, dry eye disorder, dermatitis, Mee's lines, alopecia, and hair depigmentation. Clinicians should consider MT-45 as part of their differential diagnosis if a patient is experiencing an uncommon adverse effect associated with MT-45.