Mouthwash overdose

Listerine overdose; Antiseptic mouth rinse overdose

Mouthwash overdose occurs when someone uses more than the normal or recommended amount of this substance. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, 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.

The ingredients in mouthwash that can be harmful in large amounts are:

Chlorhexidine gluconate
Ethanol (ethyl alcohol)
Hydrogen peroxide
Methyl salicylate

Where Found

Many brands of mouthwash contain the ingredients listed above.

Symptoms

Symptoms of a mouthwash overdose include:

Abdominal pain
Burns and damage to the clear covering of the front of the eye (if it gets in the eye)
Coma
Diarrhea
Dizziness
Drowsiness
Headache
Low body temperature
Low blood pressure
Low blood sugar
Nausea
Rapid heart rate
Rapid, shallow breathing
Skin redness and pain
Slowed breathing
Slurred speech
Throat pain
Uncoordinated movement
Unconsciousness
Unresponsive reflexes
Urination problems (too much or too little urine)
Vomiting (may contain blood)

Home Care

Seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to.

Before Calling Emergency

Have this information ready:

Person's age, weight, and condition
Name of the product (ingredients and strength, if known)
Time it was swallowed
Amount swallowed

Poison Control

Your local poison control 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 national hotline number will let you talk to experts in poisoning. They will give you further instructions.

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. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container to the hospital with you, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may done include:

Chest x-ray
ECG (electrocardiogram, or heart tracing)
Endoscopy -- camera down the throat to look for burns in the esophagus and stomach

Treatment may include:

Fluids through a vein (by IV)
Medicines to treat symptoms
Activated charcoal
Laxative
Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)
Kidney dialysis (kidney machine) (in serious cases)

The person may be admitted to the hospital.

Outlook (Prognosis)

How well someone does depends on the amount of mouthwash that was swallowed and how quickly treatment is received. The faster medical help is given, the better the chance for recovery.

Drinking large amounts of mouthwash may cause symptoms similar to drinking large amounts of alcohol (drunkenness). Swallowing large amounts of methyl salicylate and hydrogen peroxide may also cause serious stomach and intestine symptoms. It can also lead to changes in the body's acid-base balance.

References

Hoyte C. Caustics. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 148.

Ling LJ. The alcohols: ethylene glycol, methanol, isopropyl alcohol, and alcohol-related complications. In: Markovchick VJ, Pons PT, Bakes KM, Buchanan JA, eds. Emergency Medicine Secrets. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 70.

Nelson ME. Toxic alcohols. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 141.