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Menthol overdose

Definition

This poisoning is from swallowing pure menthol.

Poisonous Ingredient

Menthol

Where Found

Menthol is used as a flavoring agent for candy, gum, cigarettes, cough drops, and other products. It may also be found in:

• Peppermint oil
• Cold sore medications
• Ointments to treat aches and pains (Ben-Gay, Therapeutic Mineral Ice)
• Inhalants, lozenges, or ointments to treat nasal congestion
• Creams and lotions to relieve itching
• Medications to treat sore mouth, throat, or gums
• Mouthwashes

Note: This list may not be all inclusive.

Symptoms

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

Home Treatment

If the menthol is in ointment/cream form, wipe away any that remains on the skin's surface. Call Poison Control for further guidance. Seek immediate emergency medical care.

Before Calling Emergency

Determine the following:

• The patient's age, weight, and condition
• The name of the product (ingredients and strengths, if known)
• The time it was swallowed
• The 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 U.S. 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 National Poison Control center.

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. The patient may receive:

• Fluids
• Medicines to treat symptoms
• Activated charcoal
• A nasogastric (NG) tube thru the nose into the stomach to empty the stomach (gastric lavage) 
• Medicines to treat an allergic reaction (diphenhydramine, epinephrine, or prednisone)
• Endoscopy -- the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach
• Medicine (antidote) to reverse the effect of the poison
• Irrigation (washing of the skin), perhaps every few hours for several days

Expectations (prognosis)

How well a patient does depends on how much poison was swallowed and how quickly medical treatment was received. 

Swallowing pure menthol can be deadly. One teaspoonful can cause death in infants. 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.

Review Date:3/13/2006
Reviewed By:Eric Perez, MD, Department of Emergency Medicine, St. Luke's-RooseveltHospital Center, New York, NY. Review provided by VeriMed HealthcareNetwork.

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