Reactions 818 - 9 Sep 2000

O SRiluzole overdose

Methaemoglobinaemia: case reportA 43-year-old woman with amyotrophic lateral sclerosis

developed methaemoglobinaemia after taking an intentionaloverdose of riluzole.

The woman had been treated with riluzole for 2 years whenshe ingested 2.8g of riluzole. She was hospitalised 6 hoursafter taking the overdose with dyspnoea, drowsiness, a HR of100 beats/min, peripheral cyanosis and a Glasgow coma scoreof 13. Her whole blood methaemoglobin level was 18.3%. HerPCO2 was slightly elevated at 47mm Hg and her PO2 wasslightly low at 73mm Hg.

The woman was treated with gastric lavage, activatedcharcoal and methylthioninium chloride [methylene blue].Three days later, mechanical ventilation was initiated due toalveolar hypoventilation. She was weaned from the ventilatorafter 2 days, but she developed acute respiratory failure relatedto amyotrophic lateral sclerosis and died 2 days later.

Author comment: ‘Riluzole or one of its metabolites couldact as an oxidant, since it is an aminic compound, as are someother products that induce methemoglobinemia.’Viallon A, et al. Methemoglobinemia due to riluzole. New England Journal ofMedicine 343: 665-666, 31 Aug 2000 - France 800839248

1

Reactions 9 Sep 2000 No. 8180114-9954/10/0818-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved