Food supplements are regularly found to contain pharmacologically active substances. Recently, the food supplement Dexaprine was removed from the Dutch market because it was associated with severe adverse events. Reports to the Dutch Poisons Information Center (DPIC) showed that ingestion of as little as half a tablet caused several cases of nausea, agitation, tachycardia, and palpitations and even one case of cardiac arrest. The remaining tablets of four patients were sent in by different healthcare professionals. Analysis by ultra-performance liquid chromatography quadrupole time of flight mass-spectrometry (UPLC-QTOF-MS) confirmed the presence of synephrine, oxilofrine, deterenol, yohimbine, caffeine, and theophylline. Two more compounds were found which were tentatively identified as β-methyl-β-phenylethylamines. This incident is only the next in a series of similar incidents involving dietary supplements with (undeclared) active substances that are either unsafe or have no known safety profile.

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Background After changes in European Union biocide legislation, the Dutch Poisons Information Center observed a strong increase in information requests concerning dogs and cats exposed to α‐chloralose. To investigate whether α‐chloralose‐based rodenticides are safe for non‐professional use, additional information regarding poisoning scenarios and clinical course was collected. Methods Veterinarians reporting α‐chloralose exposure over a 2.5‐year period were contacted by mail for follow‐up information concerning exposure scenario, product formulation, clinical course and treatment, and outcome. In total, information was collected for 96 dogs and 41 cats. Results Fifty‐three of 96 dogs and 17 of 19 cats known to have been exposed to α‐chloralose‐based rodenticides developed signs of central nervous system (CNS) depression or sensory‐induced CNS excitation. Mortality in dogs and cats following exposure was 1% and 18%, respectively. An additional 22 cats presented with clinical signs suggestive of α‐chloralose poisoning, with a mortality of 5%. Limitations Exposure to α‐chloralose was not confirmed by biochemical analyses. Conclusion Dogs and especially cats were at risk of poisoning from α‐chloralose. If criteria such as acute toxicity and risk of (secondary) poisoning are applied during the approval of α‐chloralose‐based rodenticides, similar to anticoagulant‐based rodenticides, it can be concluded that α‐chloralose is also not safe for non‐professional use.