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Clinical Pediatrics
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Rhabdomyolysis Complicating Doxylamine Overdose

Fernando S. Mendoza

Stanford School of Medicine, Children's Hospital at Stanford, Palo Alto, California

Joshua O. Atiba

Stanford School of Medicine, Children's Hospital at Stanford, Palo Alto, California

Alan M. Krensky

Stanford School of Medicine, Children's Hospital at Stanford, Palo Alto, California

Lynne M. Scannell

Stanford School of Medicine, Children's Hospital at Stanford, Palo Alto, California

A 16-year-old male presenting with anticholinergic symptoms was found to have hematuria and oliguria. Evaluation of the patient revealed a serum creatinine of 2.2 mg/d1, myoglobinuria, and a creatine phosphokinase (CPK) level of 78, 750 IU/1 with 99 percent fraction 3 isoenzyme. A toxic screen showed the presence of doxylamine, an antihistamine of the ethanolamine class, at a level of 75 times therapeutic. The patient did not have a history of trauma or seizures. The extremely high CPK level with the doxylamine overdose suggests that doxylamine may be associated with nontraumatic rhabdomyolysis. This is the first case report of rhabdomyolysis being associated with an antihistamine overdose.

Clinical Pediatrics, Vol. 26, No. 11, 595-597 (1987)
DOI: 10.1177/000992288702601109
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Y.-I. Jo, J.-O. Song, J.-H. Park, S.-Y. Koh, S.-M. Lee, T.-H. Seo, and J.-H. Lee
Risk factors for rhabdomyolysis following doxylamine overdose
Human and Experimental Toxicology, August 1, 2007; 26(8): 617 - 621.
[Abstract] [PDF]