Severe rhabdomyolysis after doxylamine overdose

Area of Science:

• Pharmacology
• Toxicology
• Nephrology

Background:

• Doxylamine succinate is a common over-the-counter (OTC) antihistamine.
• OTC antihistamines are widely accessible, increasing risks of intentional and unintentional overdose.
• Rhabdomyolysis is a serious condition involving muscle breakdown.

Observation:

• Patients ingesting doxylamine succinate and other OTC antihistamines may develop rhabdomyolysis.
• Easy availability of these medications poses risks for both adult overdose and pediatric accidental ingestion.
• Clinical presentation can range from uncomplicated to severe acute renal failure.

Findings:

• Rhabdomyolysis is a significant complication associated with doxylamine succinate and OTC antihistamine ingestion.
• The accessibility of these drugs elevates the potential for misuse and accidental exposure.
• Monitoring renal function, urine output, and serum creatine kinase is crucial.

Implications:

• Clinicians must maintain a high index of suspicion for rhabdomyolysis in patients with suspected antihistamine overdose.
• Early recognition and intervention are critical for preventing progression to acute kidney injury.
• Awareness of these risks is essential for public health, particularly concerning vulnerable populations like children.