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Ingestions of benzydamine-containing vaginal preparations

Objective. Benzydamine is a non-steroidal antiinflammatory drug used as vaginal lavage for non-specific vaginitis. Data on overdoses are scarce despite its wide availability. Methods. Retrospective analyses of single ingestions of benzydamine vaginal irrigation products from January 1991 to December 2003 reported to the Spanish Poison Control Centre. Results. 724 cases met the inclusion criteria; 86.2% of the patients were over age 14 years. Gender was not a factor in young children but 80.9% of patients older than 14 years were female. In 85.9% of cases, benzydamine was ingested when it was mistaken for an oral preparation or for an oral antiseptic. The rest were unintentional exposures in children (13.8%) or suicidal attempts (0.3%). Clinical signs or symptoms, when present, were mainly gastrointestinal (48% of symptomatic patients) followed by neurological (31%) or both (21%). The most common symptom was nausea (32.8% of symptomatic patients) followed by vomiting (27.9%), dizziness (20.1%), hallucinations (15.3%), abdominal pain (13.4%), and esophageal irritation and agitation (10.5%, each). Six of 68 children (mean age 6.2, range 3–11 years) had hallucinations. A severe case was that of a 4-year-old child who had convulsions caused by the unintentional ingestion of benzydamine. Conclusion. This is the largest report of benzydamine ingestions. The outstanding feature was the high percentage of neurological manifestations in children and adults, mainly hallucinations, following the ingestion of an over-the-counter product.