Merthiolate poisoning: MedlinePlus Medical Encyclopedia

P Merthiolate is a mercury-containing substance that was once widely used as germ-killer and a preservative in many different products, including vaccines.
P Merthiolate poisoning occurs when large amounts of the substance are swallowed or come in contact with your skin. Poisoning may also occur if you are exposed to small amounts of merthiolate constantly over a long period of time.
P This article is for information only. Do NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

T Poisonous Ingredient
P Thimerosal

T Where Found
P Merthiolate is found in:
- Merthiolate
- Some eye drops
- Some nasal drops
P The FDA banned the use of Merthiolate in over-the-counter products in the late 1990s.

T Symptoms
P Symptoms of Merthiolate poisoning include:
- Abdominal pain
- Diarrhea
- Decreased urine output
- Drooling
- Extreme difficulty breathing
- Metallic taste
- Memory problems
- Mouth sores
- Seizures
- Shock
- Skin numbness
- Swelling in the throat, which may be severe
- Thirst
- Walking problems
- Vomiting, sometimes bloody

T Home Care
P If you are concerned about a possible overdose, contact your local poison control center for advice.

T Before Calling Emergency
P The following information is helpful for emergency assistance:
- Person's age, weight, and condition
- Name of the product (ingredients and strengths, if known)
- Time it was swallowed
- Amount swallowed
P However, DO NOT delay calling for help if this information is not immediately available.

T Poison Control
P Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions.
P This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. You can call 24 hours a day, 7 days a week.

T What to Expect at the Emergency Room
P The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:
- Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
- Blood and urine tests
- Camera down the throat (endoscopy) to see burns in the food pipe (esophagus) and stomach
- Chest x-ray
- EKG (electrocardiogram, or heart tracing)
- Fluids through a vein (intravenous or IV)
- Medicines to treat symptoms, including chelators, which remove mercury from the bloodstream and may reduce long-term injury

T Outlook (Prognosis)
P Merthiolate poisoning is difficult to treat. How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery. Kidney dialysis (filtration) through a machine may be needed if the kidneys do not recover after acute mercury poisoning, Kidney failure and death can occur, even with small doses.

T References
P Aronson JK. Mercury and mercurial salts. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:844-852.
P National Library of Medicine, Toxicology Data Network. Thimerosal. Updated June 23, 2005. toxnet.nlm.nih.gov. Accessed February 9, 2017.

T Review Date 1/31/2017
P Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

