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Sunday, May 6th 2007

Watch Out For Diethylene Glycol

Watch out for contaminated drugs, says the FDA. Watch out for medicine contaminated with DEG.

Some Chinese suppliers have used poisonous diethyline glycol, or DEG, as a substitute for glycerin, a more expensive sweet syrup, in cough medicine, fever medication and injectable drugs, the New York Times reported today. Researchers estimate that thousands of deaths worldwide have been caused by drugs contaminated by DEG, an industrial solvent and an ingredient in some antifreeze, the newspaper said.

The FDA “is emphasizing the importance of testing glycerin for DEG due to the serious nature of this potentially fatal problem in combination with the global nature of the pharmaceutical supply chain and problems that continue to occur,” the agency said in the statement released May 4.

We’ve been down this road before. In the 90s nearly a hundred children died from Diethylene Glycol tainted acetaminophen. Indeed, in 1937 DEG use in a medication in the US led to the law giving the FDA its current powers.

During September and October 1937 [Elixir Sulfanilamid] was responsible for the deaths of more than 100 people in 15 states, as far east as Virginia and as far west as California. The drug and the deaths led to the passage of the 1938 Food, Drug, and Cosmetic Act, which increased FDA’s authority to regulate drugs.

Sulfanilamide, a drug used to treat streptococcal infections, had been shown to have dramatic curative effects and had been used safely for some time in tablet and powder form. In June 1937, however, a salesman for the S.E. Massengill Co., in Bristol, Tenn., reported a demand in the southern states for the drug in liquid form. The company’s chief chemist and pharmacist, Harold Cole Watkins, experimented and found that sulfanilamide would dissolve in diethylene glycol. The company control lab tested the mixture for flavor, appearance, and fragrance and found it satisfactory. Immediately, the company compounded a quantity of the elixir and sent shipments–633 of them–all over the country.

The new formulation had not been tested for toxicity.

Diethylene Glycol is an alcohol. Its metabolism is started by alcohol dehydrogenase, just like all alcohols. And so what do you know, you can treat poisoning with it by giving patients ethanol to use up time on the alcohol dehydrogenase enzyme and slow down the conversion of DEG to its toxic metabolites (and hopefully the body will the DEG it before it can be metabolized). There are other alcohol dehydrogenase inhibitors you can give (fomepizole) but how fun is that? Just kidding.

How this stuff keeps getting used in counterfeit or cheap foreign medications is beyond me. How slowly does word of this stuff’s toxicity spread?