Background: Dexaprine is an illegal slimming product with known serious adverse cardiac effects. Despite warnings from the Netherlands Food and Consumer Product Safety Authority, Dexaprine is still readily available online.
Case description: A 29-year-old woman was brought into the emergency room after a suicide attempt with 29 Dexaprine tablets. The symptoms on admission were agitation, nausea and vomiting, hypotension, atrioventricular nodal reentrant tachycardia and hypothermia. Extensive drug screening revealed that Dexaprine contains caffeine, amphetamine and theophylline, explaining the symptoms. The patient was admitted to the intensive care unit for supportive therapy overnight before being discharged.
Conclusions: In contrast to the advertised composition, Dexaprine contains several pharmacologically active substances including caffeine, amphetamine and theophylline. In intoxications caused by products of unknown composition, additional toxicological screening is invaluable to determine the extent and severity of intoxication. In this case, the patient's symptoms were due to theophylline intoxication. Ultimately, the theophylline levels did not indicate additional treatment such as haemodialysis.