American Association of Poison Control Centers database characterization of human tilmicosin exposures, 2001–2005

Human Health Hazards of Veterinary Medications: Information for Emergency Departments

“…Human exposure results from accidental or occupational exposures or suicide attempts, and both are associated with fatalities. There are several documented case reports of accidental or intentional injection of tilmicosin that resulted in human deaths (27)(28)(29)(30)(31)(32). Historical data are reported to document at least 13 confirmed fatalities associated with the drug worldwide from 1995-2000, most associated with intentional suicides (33).…”

“…Oakes and Seifert report that 75% of all patients exposed to tilmicosin and more than 80% of parenterally exposed persons become symptomatic (32). Minor clinical signs and symptoms are possible with injections of Ͻ 0.5 mL, whereas doses in excess of 5 mL result in fatalities (32). Investigative reports of accidental human injections report an approximate interval of 15 min from the time of injection until signs and symptoms of cardiotoxicity appear (28,29,33).…”

“…Historical data are reported to document at least 13 confirmed fatalities associated with the drug worldwide from 1995-2000, most associated with intentional suicides (33). More recently, in Oakes and Seifert's report of poison control center data, 1291 tilmicosin exposures occurred from the year 2001 to 2005, with four deaths (32). Of the four deaths, two were suicides.…”

“…Parenteral exposures involve greater toxicity than non-parenteral routes of exposure (30,32,34). Oakes and Seifert report that 75% of all patients exposed to tilmicosin and more than 80% of parenterally exposed persons become symptomatic (32). Minor clinical signs and symptoms are possible with injections of Ͻ 0.5 mL, whereas doses in excess of 5 mL result in fatalities (32).…”

“…Of the four deaths, two were suicides. On average, there are over 250 cases of human tilmicosin exposures per year reported to poison control centers (32).…”