Solvents – Propylene Glycol

SOURCE

Berg, Eric, director. Propylene Glycol Side Effects & Dangers by Dr.Berg. YouTube, YouTube, 1 Aug. 2018, www.youtube.com/watch?v=A3LyWHLja_A.

  • The video above explains the variety of uses of propylene glycol. FDA recognizes propylene glycol as generally safe, and humans are typically exposed through ingestion of food and skin contact with cosmetic or topical medications. Propylene glycol is also found in many pharmaceuticals, including:
      • phenytoin
      • diazepam
      • lorazepam

 

SIGNS AND SYMPTOMS OF TOXICITY

  • If too much propylene glycol is ingested over a short period, iatrogenic propylene glycol overdose can cause the following (2):
      • Hyperosmolaity and an anion gap metabolic acidosis
      • Refractory hypotension
      • Arrhythmias
      • Hemolysis
      • Renal dysfunction
      • Seizure
      • Coma 
  • Children may also experience CNS depression and seizures (2). 

 

MECHANISM OF ACTION

  • Propylene glycol is absorbed rapidly from the gastrointestinal tract. The plasma concentrations in humans occur 1 hour after ingestion. The liver metabolizes propylene glycol by alcohol dehydrogenase into lactic acid and pyruvic acid, which are further metabolized into carbon dioxide and water (2).

Jeffrey A. Kraut, Ira Kurtz Toxic Alcohol Ingestions: Clinical Features, Diagnosis, and Management CJASN Jan 2008, 3 (1) 208-225; DOI: 10.2215/CJN.03220807

 

TOXICOKINETICS

  • No adverse effects have been found with the normal use of pharmaceuticals containing propylene glycol. Prolonged or extensive topical application can cause excess propylene glycol levels in your body (3). 
  • Foods containing propylene glycol have shown a remarkably consistent low toxicity hazard, demonstrated with acute, short term, and chronic exposures studied on animal models (2). 
  • Human systematic toxicity (2):
    • Virtually unknown with normal propylene glycol levels. 
    • Acute ingestion or intravenous intoxications involving extremely high doses in critically ill or susceptible patients can show toxicity. Even in these extreme cases, complete recovery is expected. However, transient signs of altered nervous system function (commonly observed with short-chain glycol exposure) may occur with exposure to high doses.

 

TARGET ORGANS

  • The main target organ affected by propylene glycol poisoning is the kidneys (2). The hyperosmolality is often accompanied by acute kidney injury leading to multi-system organ failure (2). Additionally, increased serum creatinine concentrations and proximal renal tubular cell injury distinguish renal dysfunction of some propylene glycol poisonings (2).

 

 

Resources:

  1. Berg, Eric, director. Propylene Glycol Side Effects & Dangers by Dr.Berg. YouTube, YouTube, 1 Aug. 2018, www.youtube.com/watch?v=A3LyWHLja_A. 
  2. “Ethylene Glycol and Propylene Glycol Toxicity: What Is Propylene Glycol?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 Oct. 2020, www.atsdr.cdc.gov/csem/ethylene-propylene-glycol/propylene_glycol.html.
  3. Fowles JR, Banton MI, Pottenger LH. A toxicological review of the propylene glycols. Crit Rev Toxicol. 2013 Apr;43(4):363-90. doi: 10.3109/10408444.2013.792328. PMID: 23656560. 
  4. Jeffrey A. Kraut, Ira Kurtz CJASN Jan 2008, Toxic Alcohol Ingestions: Clinical Features, Diagnosis, and Management3 (1) 208-225; DOI: 10.2215/CJN.03220807

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