Pulmonary effects of i.v. injection of crushed oral tablets: "excipient lung disease"

AJR Am J Roentgenol. 2014 Nov;203(5):W506-15. doi: 10.2214/AJR.14.12582.


Objective: When crushed oral tablets are injected i.v., their filler material (excipient) can induce a potentially fatal foreign-body reaction in pulmonary arterioles, presenting as dyspnea and pulmonary hypertension with centrilobular nodules on CT. We will describe the imaging and pathologic features of "excipient lung disease."

Conclusion: The radiologist has a critical role in recognizing and reporting excipient lung disease because the referring clinician may be unaware of the patient's i.v. drug abuse.

Keywords: centrilobular nodules; drug abuse; excipient; microcrystalline cellulose; oral tablet; pulmonary arterial hypertension; talc.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Diagnosis, Differential
  • Excipients / poisoning*
  • Female
  • Foreign-Body Migration / diagnostic imaging*
  • Foreign-Body Migration / etiology*
  • Humans
  • Injections, Intravenous*
  • Lung Injury / diagnostic imaging*
  • Lung Injury / etiology*
  • Male
  • Middle Aged
  • Radiography
  • Substance Abuse, Intravenous / complications*


  • Excipients