Cough syrups could be deadly. That's the warning being sent by coroners in Quebec who investigated the recent deaths of two men.
The men, aged 64 and 65, died within a month of each other last spring after taking cough syrup containing the cough suppressant dextromethorphan, or DM.
One of the men overdosed on dextromethorphan. The other took the medicine while he was taking the antidepressant Prozac and an antibiotic. It proved to be a killer combination.
According to the coroners' report, the first man had developed the flu but had failed to see a doctor. He was trying to manage his symptoms at home and overdosed on a toxic level of dextromethorphan. He was found dead by a family member. After conducting an autopsy, the coroners concluded that the man had a toxic level of DM in his system and must have exceeded the maximum dosage spelled out on the cough syrup label.
The second man had bipolar disorder and was taking Prozac. He developed bronchitis and after two weeks, went to see his family doctor. He was prescribed a 15-day course of the antibiotic Biaxin and advised to continue taking cough syrup to manage his cough symptoms. He was found dead three days later.
The coroners concluded that the combination of Prozac and dextromethorphan along with the antibiotic proved lethal.
The coroners are asking the province to make it mandatory for cough syrups to be placed behind the counter. That way, a pharmacist can advise patients about dosages as well as ask them about any other medication they might be taking to look for any problematic combinations.
According to the coroner's report, between 2000 and 2009, at least 20 people have died after taking over-the-counter cough and cold medications containing DM, acetaminophen or ASA (found in aspirin and other meds).
"Anyone can buy these products at will without consulting with a pharmacist or doctor and may knowingly or unknowingly ignore the recommended dosage on the container," they write.
The coroners recommend that the Order of Pharmacists of Quebec request its members to take cough suppressant medications off the shelves now and place them behind the counter, even before any change in legislation.
A copy of the Coroner's report has been sent to Health Canada.
