Beware the yellow slimming pill: fatal 2,4-dinitrophenol overdose
Open accessAbstract
An industrial chemical, 2,4-dinitrophenol (DNP), has found use as a weight loss drug. It is extremely toxic in overdose and has a narrow therapeutic window with significant interindividual variability in metabolism. The rise in internet-based sales and distribution of this drug has seen an increased incidence of both accidental and intentional overdose presenting to emergency departments across the UK. No antidote currently exists and overdose is often fatal despite management based on current recommendations. We report a case of intentional overdose of DNP in a young man and discuss the current treatment guidelines. The case highlights the need for an increased awareness among frontline medical staff of the effects of DNP poisoning and questions the need for a more aggressive approach in the management of acute toxicity.
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More recently, an increase in the use of DNP as self-medication has been observed in China and the United Kingdom, leading to new cases of DNP-associated fatalities.
“More recently, an increase in the use of DNP as a self-medication has been observed in China [266] and the United Kingdom [267], leading to new cases of DNP-associated fatalities.”
From Mitochondrial Uncoupling: A Key Controller of Biological Processes in Physiology and Diseases (2019) · cites this paper as [267]
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Cites
Dantrolene – A review of its pharmacology, therapeutic use and new developments
Krause, T., Gerbershagen, M. U., Fiege, M., Weißhorn, R., & Wappler, F. (2004) · Anaesthesia · doi:10.1111/j.1365-2044.2004.03658.x · Cited by 578 · see citing works
2,4-Dinitrophenol (DNP): A Weight Loss Agent with Significant Acute Toxicity and Risk of Death
Grundlingh, J., Dargan, P. I., El-Zanfaly, M., & Wood, D. M. (2011) · Journal of Medical Toxicology · doi:10.1007/s13181-011-0162-6 · Cited by 470 · see citing works
Toxicity of Weight Loss Agents
Yen, M., & Ewald, M. B. (2012) · Journal of Medical Toxicology · doi:10.1007/s13181-012-0213-7 · Cited by 132 · see citing works
Deliberate poisoning with dinitrophenol (DNP): an unlicensed weight loss pill
Bartlett, J., Brunner, M., & Gough, K. (2010) · Emergency Medicine Journal · doi:10.1136/emj.2008.069401 · Cited by 56 · see citing works
Clinical features and treatment in patients with acute 2,4-dinitrophenol poisoning
Lu, Y., Jiang, J.-K., & Huang, W. (2011) · Journal of Zhejiang University SCIENCE B · doi:10.1631/jzus.b1000265 · Cited by 54 · see citing works
Kamour, A., George, N., Gwynnette, D., Cooper, G., Lupton, D., Eddleston, M., Thompson, J. P., Vale, J. A., Thanacoody, H. K. R., Hill, S., et al. (2015) · Emergency Medicine Journal · doi:10.1136/emermed-2013-203335 · Cited by 47 · see citing works
Weight loss and 2,4-dinitrophenol poisoning
Tewari, A., Ali, A., O’Donnell, A. E., & Butt, M. S. (2009) · British Journal of Anaesthesia · doi:10.1093/bja/aep033 · Cited by 42 · see citing works
'Fatal 2,4-dinitrophenol poisoning... coming to a hospital near you'
Siegmueller, C., & Narasimhaiah, R. (2010) · Emergency Medicine Journal · doi:10.1136/emj.2009.072892 · Cited by 32 · see citing works
Surviving a life-threatening 2,4-DNP intoxication: 'Almost dying to be thin'.
van Veenendaal, A., Baten, A., & Pickkers, P. (2011) · PubMed · Cited by 9 · see citing works
(2002) · Journal of Toxicology Clinical Toxicology · doi:10.1081/clt-120016859 · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Bradbury S, Vale J. Phenol and related compounds. In: Beteman D, Jefferson R, et al, eds. Oxford desk reference: toxicology. Oxford University Press. 2011:258-9.
- Kumar S, Barker K, Seger D. Dinitrophenol-induced hyperthermia resolving with dantrolene administration. Abstracts of the North American Congress of Clinical Toxicology. Clin Toxicol 2002;40:599-673.
Cited by
Sorted by citations
Mitochondrial Uncoupling: A Key Controller of Biological Processes in Physiology and Diseases
Demine, S., Renard, P., & Arnould, T. (2019) · Cells · doi:10.3390/cells8080795 · Cited by 476 · see citing works
“More recently, an increase in the use of DNP as a selfmedication has been observed in China [266] and the United Kingdom [267], leading to new cases of DNP-associated fatalities.”
BackgroundGoedeke, L., Perry, R. J., & Shulman, G. I. (2019) · The Annual Review of Pharmacology and Toxicology · doi:10.1146/annurev-pharmtox-010716-104727 · Cited by 76 · see citing works
Bonnecaze, A. K., O’Connor, T., & Burns, C. A. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-06751-3 · Cited by 75 · see citing works
Roden, A. C., & Camus, P. (2018) · Seminars in Diagnostic Pathology · doi:10.1053/j.semdp.2018.03.002 · Cited by 53 · see citing works
Diet aid or aid to die: an update on 2,4-dinitrophenol (2,4-DNP) use as a weight-loss product
de Sousa, D., Carmo, H., Bravo, R. R., Carvalho, F. D., Bastos, M. D. L., de Pinho, P. G., & da Silva, D. D. (2020) · Archives of Toxicology · doi:10.1007/s00204-020-02675-9 · Cited by 38 · see citing works
Ashraf, A. R., Mackey, T. K., Vida, R. G., Kulcsár, G., Schmidt, J., Balázs, O., Domián, B. M., Li, J., Csákó, I., & Fittler, A. (2024) · Journal of Medical Internet Research · doi:10.2196/65440 · Cited by 28 · see citing works
Barriers and Solutions for Prescribing Obesity Pharmacotherapy
Fujioka, K., & Harris, S. R. (2020) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2020.02.007 · Cited by 28 · see citing works
2,4 dinitrophenol: It's not just for men
Germain, J., Leavey, C., Hout, P. M. C. V., & McVeigh, P. J. (2020) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2020.102987 · Cited by 25 · see citing works
Death of an apprentice bodybuilder following 2,4-dinitrophenol and clenbuterol intake
Dufayet, L., Gorgiard, C., Vayssette, F., Barbet, P., Hoizey, G., & Ludes, B. (2020) · International Journal of Legal Medicine · doi:10.1007/s00414-020-02268-2 · Cited by 20 · see citing works
Toxicoepidemiology and predictors of death in 2,4-dinitrophenol (DNP) toxicity
Potts, A. J., Bowman, N., Seger, D., & Thomas, S. H. L. (2020) · Clinical Toxicology · doi:10.1080/15563650.2020.1826505 · Cited by 15 · see citing works
de Campos, E. G., Fogarty, M. F., Martinis, B. S. D., & Logan, B. K. (2019) · Journal of Forensic Sciences · doi:10.1111/1556-4029.14154 · Cited by 15 · see citing works
Physiologically-based pharmacokinetic model for 2,4-dinitrophenol
Meyer, L. F., Rajadhyaksha, P. M., & Shah, D. K. (2022) · Journal of Pharmacokinetics and Pharmacodynamics · doi:10.1007/s10928-022-09806-y · Cited by 13 · see citing works
Role of dantrolene in dinitrophenol (DNP) overdose: A continuing question?
Kopec, K. T., Kim, T., Mowry, J. B., Aks, S., & Kao, L. W. (2019) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2019.03.035 · Cited by 12 · see citing works
Dantrolene is not the answer to 2,4-dinitrophenol poisoning: more heated debate
Schoor, J. V., Khanderia, E., & Thorniley, A. (2018) · BMJ Case Reports · doi:10.1136/bcr-2018-225323 · Cited by 11 · see citing works
Bleasdale, E. E., Thrower, S. N., & Petróczi, A. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00124 · Cited by 10 · see citing works
2,4-Dinitrophenol overdose - Everything old is new again
Griffiths, A., Milne, N., Ong, B. B., & Watkins, T. W. (2021) · Journal of Forensic and Legal Medicine · doi:10.1016/j.jflm.2021.102148 · Cited by 9 · see citing works
Luminescence turn-off detection of metal ions and explosives using graphene quantum dots
Jyotsna, S., Sadhu, S., Sharma, V., Gupta, P., Sharma, G., & Poddar, P. (2022) · MRS Communications · doi:10.1557/s43579-022-00157-w · Cited by 7 · see citing works
Kopec, K. T., Freiermuth, C. E., Maynard, S. M., & Beuhler, M. C. (2018) · Journal of Medical Toxicology · doi:10.1007/s13181-018-0677-1 · Cited by 7 · see citing works
Hermetet, C., Jourdan, M., Baert, A., Gheddar, L., Ameline, A., Kintz, P., & Bouvet, R. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1452196 · Cited by 5 · see citing works
Liu, Y., Yamamoto, T., Kohaya, N., Yamamoto, K., Okano, K., Sumiyoshi, T., Hasegawa, Y., Lau, P. C. K., & Iwaki, H. (2023) · Journal of Bioscience and Bioengineering · doi:10.1016/j.jbiosc.2023.05.013 · Cited by 5 · see citing works
McGillis, E. S., Olives, T. D., Love, S. A., & Cole, J. B. (2020) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201908-574cc · Cited by 5 · see citing works
Pharmacological Management of Obesity: A Century of Expert Opinions in Cecil Textbook of Medicine
Manu, P., Lăcătușu, C.-M., Rogozea, L. M., & Cernea, S. (2022) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000001524 · Cited by 5 · see citing works
Lindeman, E., Sommer, T., Leffler, M., Sekine, S., Elmér, E., Sjövall, F., & Wallquist, W. (2025) · Toxicology Reports · doi:10.1016/j.toxrep.2025.102183 · Cited by 4 · see citing works
Molecular mechanisms of mitochondrial uncoupling: focus on 2,4-dinitrophenol
Pohl, E. E., & Jovanović, O. (2026) · European Biophysics Journal · doi:10.1007/s00249-026-01827-6 · Cited by 4 · see citing works
2,4-dinitrophenol intoxication and its morphological findings as an indication of substance intake
Gummesson, A., Zack, F., & Buettner, A. (2024) · Journal of Pharmaceutical and Biomedical Analysis · doi:10.1016/j.jpba.2024.116498 · Cited by 4 · see citing works
Fatal poisoning with 2,4-Dinitrophenol: learning via case study
Newport, M., & Said, T. (2020) · Journal of Paramedic Practice · doi:10.12968/jpar.2020.12.2.cpd1 · Cited by 4 · see citing works
Death from 2,4-Dinitrophenol Poisoning: An Autopsy Case
Jung, M., Lee, S. J., Yoo, S. H., & Kim, H.-S. (2020) · Korean Journal of Legal Medicine · doi:10.7580/kjlm.2020.44.3.140 · Cited by 3 · see citing works
Further elucidation of the metabolism of 2,4-dinitrophenol in a case of unexpected death
Vanthourenhout, S., Deprez, C., Maes, P., Carlier, L., Hoorick, M. V., Heylen, O., Mulliez, S., & Croes, K. (2026) · Journal of Analytical Toxicology · doi:10.1093/jat/bkag003 · Cited by 2 · see citing works
Liver toxicity produced by the weight reducing agent 2,4 dinitrophenol
Abdel‐Salam, O. M. E., Morsy, F. A., Medhat, D., Yassen, N. N., & Shabana, M. E.-A. (2023) · Drug Discovery · doi:10.54905/disssi.v17i39.e2dd1002 · Cited by 2 · see citing works
. Pesticides: current trends in the use and epidemiology of acute poisoning (literature review)
Рожков, П. Г., Gasimova, Z. M., Бухарин, Ю. Ю., Sokolova, T. A., Severtsev, V. V., & Lezhenina, N. F. (2024) · Extreme Medicine · doi:10.47183/mes.2024-26-3-77-86 · Cited by 1 · see citing works
Managing a deliberate 2,4-dinitrophenol overdose: A case report
Yee, S., Le, P. T., Gaitsgory, O., Lee, H. M., & Subramaniam, A. (2025) · Anaesthesia and Intensive Care · doi:10.1177/0310057x251381375 · Cited by 1 · see citing works
Yamamoto, T., Liu, Y., Kohaya, N., Hasegawa, Y., Lau, P. C. K., & Iwaki, H. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/749879 · Cited by 1 · see citing works
Intoxicación letal por dinitrofenol
Valdivia-Infantas, M. M., & Hidalgo-Arroyo, E. (2022) · Boletín de la Sociedad Peruana de Medicina Interna/Revista de la Sociedad Peruana de Medicina Interna · doi:10.36393/spmi.v35i4.697
- Authors
- Holborow, A., Purnell, R. M., & Wong, J. F.
- Affiliations
- Cardiff University (GB)
- Department of Medicine and Cardiology, Abertawe Bro Morgannwg University Health Board, Swansea, UK
- Department of Surgery, Abertawe Bro Morgannwg University Health Board, Swansea, UK
- Corresponding author
- Holborow, Alexander
- Venue
- BMJ Case Reports
- Publisher
- BMJ
- Published
- 2016-04-04
- Volume
- 2016
- Pages
- bcr2016214689
- ISSN
- 1757-790X (ISSN-L)
- PMC
- PMC4840695
- OpenAlex
- W2337916199
- Cited by
- 34
- References
- 10
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 9 · 2019: 5 · 2018: 4
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ Case Reports (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Plant-based Medicinal Research
- Keywords
- 2,4-dinitrophenol, anti-obesity drugs, intentional overdose, fatal overdose, online drug sales, emergency department management
- MeSH terms
- Humans, Male, Suicide, Attempted, Fatal Outcome, 2,4-Dinitrophenol, Anti-Obesity Agents, Young Adult, Drug Overdose
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