Acute toxicity profile of tolperisone in overdose: Observational poison centre-based study

Martos, Viktor; Hofer, Katharina E.; Rauber-Lüthy, Christine; Schenk-Jaeger, Katharina M.; Kupferschmidt, Hugo; Ceschi, Alessandro

doi:10.3109/15563650.2015.1022896

Cited by 10 publications

(4 citation statements)

References 20 publications

(22 reference statements)

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“…The toxicity of toperidone hydrochloride, methyl hesperidin, and vitamin B6 has not been reported before. The side effects of tolperisone hydrochloride reported at present is not clear (Ribi et al, 2003; Sporkert et al, 2012; Martos et al, 2015). In animal studies, methyl hesperidin has not been found to have toxic or side effects before (Kawabe et al, 1993).…”

Section: Discussionmentioning

confidence: 81%

Untargeted Safety Pharmacology Screen of Blood-Activating and Stasis-Removing Patent Chinese Herbal Medicines Identified Nonherbal Ingredients as a Cause of Organ Damage in Experimental Models

Shao

Yang

et al. 2019

Front. Pharmacol.

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Blood activation and stasis removal from circulation is a central principle for treatment of syndromes related to cerebral and cardiovascular diseases in Chinese herbal medicine. However, blood-activating and stasis-removing patent Chinese herbal medicine (BASR-pCHM) widely used with or without prescription in China and elsewhere are highly variable in composition and manufacture standard, making their safety assessment a challenging task. We proposed that an integrated evaluation of multiple toxicity parameters of BASR-pCHM would provide critical reference and guidelines for their safe clinical application. Examination of standardized extracts from 58 compound BASR-pCHM in vivo in VEGFR2-luc mice and in vitro in cardiac, renal, and hepatic cells identified Naoluotong capsule (NLTC) as a potent organ/cell damage inducer. Composition analysis revealed that NLTC was the one that contained nonherbal ingredients among the BASR-pCHM collection. In vivo and in vitro experiments confirmed that NLTC, as well as its chemical supplement tolperisone hydrochloride, caused organ and cell damage by reducing cell viability, mitochondrial mass/activity, while the NLTC herbal components did not. Taken together, our study showed that safety evaluation of patent herbal medicines already on market is still necessary and urgently needed. In addition, chemical/herbal interactions should be considered as an important contributor of potential toxicity when evaluating the safety of herbal medicine.

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Section: Discussionmentioning

confidence: 81%

Untargeted Safety Pharmacology Screen of Blood-Activating and Stasis-Removing Patent Chinese Herbal Medicines Identified Nonherbal Ingredients as a Cause of Organ Damage in Experimental Models

Shao

Yang

et al. 2019

Front. Pharmacol.

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“…A common trend seen over the included studies was that the intent behind the pharmaceutical poisoning varied depending on age. Fifteen of the studies reported on pharmaceutical poisoning in children, of which 70.2% were exposed accidently (n = 76,398) [42,49,61,67,75,76,78,82,86,91,92,[94][95][96][97]. Five studies had separated results for adult exposure where 80.9% of exposures were intentional (n = 725) [73,78,94,96,98].…”

Section: Low-middle-income Countries (N = 21)mentioning

confidence: 99%

Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review

Cowans,

Love,

Tangiisuran

et al. 2023

Pharmacy

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Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths annually. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1 January 2011 to 31 December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. Toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes due to poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.

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“…(Figure 2) A common trend seen over the included studies was that the intent behind the pharmaceutical poisoning varied depending on age. Fifteen of the studies reported on pharmaceutical poisoning in children, of which 70.2% were exposed accidently (n=76,398) [38,45,57,63,71,72,74,75,79,83,88,89,[104][105][106]. Five studies had separated results for adult exposure where 80.9% of exposures were intentional (n=725) [69,74,75,98,105].…”

Section: Reason Behind Toxic Exposurementioning

confidence: 99%

Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review

Cowans,

Love,

Tangiisuran

et al. 2023

Preprint

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Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths yearly. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1st January 2011 to 31st December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. The toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes of poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.

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Acute toxicity profile of tolperisone in overdose: Observational poison centre-based study

Cited by 10 publications

References 20 publications

Untargeted Safety Pharmacology Screen of Blood-Activating and Stasis-Removing Patent Chinese Herbal Medicines Identified Nonherbal Ingredients as a Cause of Organ Damage in Experimental Models

Untargeted Safety Pharmacology Screen of Blood-Activating and Stasis-Removing Patent Chinese Herbal Medicines Identified Nonherbal Ingredients as a Cause of Organ Damage in Experimental Models

Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review

Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review

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