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Department of Health: Warning in relation to 2,4-dinitrophenol (DNP) consumption
The Department of Health (DH), upon notification from World Health Organisation (WHO), is alerting members of the public not to use the chemical 2,4-dinitrophenol (DNP) which is sold over the Internet as a slimming aid for dieters (including those who are suffering from eating disorders or body dysmorphia) and body builders.

This industrial chemical DNP has caused cases of severe illness and deaths in multiple countries in the last 2-3 years. WHO's notification is triggered by the report of a death in the United Kingdom following the use of a product containing DNP. As a result of this death and other evidence of the continuing sale of products containing DNP, on 29 April 2015 Interpol issued a global alert, in the form of an Orange Notice warning, to law enforcement agencies in 190 countries.

DNP can be used in the manufacture of munitions, as a herbicide, and in the manufacture of dyes, wood preservatives and photographic chemicals. In the 1930s it was discovered that DNP increases metabolic rate and induces weight loss, leading to its use as a slimming drug. The high incidence of severe adverse effects and deaths resulted in the prohibition of its medical use in the USA. DNP has also been banned as a weight-loss drug in the UK.

While DNP is not a licensed drug, it is still widely sold over the Internet under a variety of names. Websites often refer to the chemical as a ‘fat burner’, implying its suitability for human consumption, even if the same website also publishes a disclaimer about the dangers of ingesting this chemical. The fact that a product contains DNP will not always be mentioned on the website or product label. Some of the websites selling the products purport to be pharmaceutical companies or claim to make products to GMP standards. Since, however, there is no regulatory control of the manufacture of products containing DNP, or in the jurisdictions where it is sold, there is no guarantee whatsoever of the quality and purity of the chemical.

DNP is sold as a yellow powder or crystals, in capsules, and as a cream. Typical quantities of DNP contained in capsules are 100 to 250 mg, and some websites sell the powder in bulk.

Some websites recommend the use of doses of 100 to 400 mg per day, usually building up to the higher dose over time. Websites might also suggest the concomitant use of thyroid hormone and/or anabolic steroids. The toxic dose is variable. The lowest published lethal dose is 4.3 mg/kg and other doses reported as being lethal range from 2.8 to 5g. Conversations around the most suitable dosing ‘cycles’ are noted in online discussion fora linked to bodybuilding. DNP is absorbed by ingestion, inhalation and through the skin. It acts by uncoupling oxidative phosphorylation and stimulating glycolysis.

The most common side effect associated with the use of DNP is a rash. Other adverse effects reported include peripheral neuritis particularly affecting the hands, gastroenteritis and anorexia, agranulocytosis and neutropaenia, cataracts, permanent deafness and yellow discolouration of the skin, sclera and urine.

Toxic effects include confusion, agitation, coma, convulsions, hyperthermia, tachycardia, sweating and tachypnoea and cardiovascular collapse. Hyperthermia may be severe and life-threatening, and body temperatures exceeding 40° C have been reported. Changes found at post-mortem include heart muscle damage and acute tubular necrosis.

There is no antidote for poisoning with DNP and management involves symptomatic and supportive care with particular attention to monitoring body temperature, cardiac rhythm, heart rate and oxygen saturation. A range of measures may be used to correct hyperthermia including external cooling measures, benzodiazepines and dantrolene.

In Hong Kong, there is no registered pharmaceutical product containing DNP. Members of the public are strongly advised not to buy or consume DNP containing products and products of unknown or doubtful composition, or consume products from unknown sources including through internet. Weight control should be achieved through a balanced diet and appropriate exercise. The public should consult healthcare professionals before using any medication for weight control.

Ends/ Monday, June 08, 2015
Issued at HKT 09:00
Related Information:
Taiwan: Members of the public should not buy or take products containing 2,4-din... Posted 2015-06-18
Warning in relation to 2,4-dinitrophenol (DNP) consumption (Letter to Healthcare... Posted 2015-06-05