'Fatal 2,4-dinitrophenol poisoning... coming to a hospital near you'

Emerg Med J. 2010 Aug;27(8):639-40. doi: 10.1136/emj.2009.072892. Epub 2010 May 29.


An adult man was brought into the emergency department after deliberate ingestion of dinitrophenol: an agent that uncouples mitochondrial oxidative phosphorylation. The patient rapidly developed a hyper-metabolic state with fever, respiratory failure and died within a few hours after admission. Dinitrophenol is used in the manufacture of dyes, pesticides and explosives. Sub-acute poisoning is associated with weight-loss and the substance had been prescribed for this purpose during the 1930s in the United States before being banned due to serious side effects. Although remaining unlicensed as a drug, dinitrophenol is widely available through mail-order websites and online pharmacies, which promote it as an anti-obesity treatment. This case highlights the need for awareness of possibly increasing rates of accidental poisoning with a growing obesity prevalence and availability of this unlicensed drug through the internet. Additionally, we discuss the use of dantrolene in dinitrophenol poisoning and question whether current Toxbase/UK National Poison Information Service treatment guidelines regarding the indication and dosing of this drug, the only relatively specific treatment in dinitrophenol poisoning presently recommended, could be revised.

Publication types

  • Case Reports

MeSH terms

  • 2,4-Dinitrophenol / poisoning*
  • Adult
  • Calcium Gluconate / therapeutic use
  • Dantrolene / therapeutic use*
  • Emergency Treatment / methods*
  • Fatal Outcome
  • Humans
  • Hyperkalemia / drug therapy
  • Hyperkalemia / etiology
  • Infusions, Intravenous
  • Male
  • Muscle Relaxants, Central / therapeutic use*
  • Poisoning / complications
  • Poisoning / drug therapy


  • Muscle Relaxants, Central
  • Dantrolene
  • 2,4-Dinitrophenol
  • Calcium Gluconate