title: A descriptive study of adverse events from clenbuterol misuse and abuse for weight loss and bodybuilding.
abstract: BACKGROUND
  Clenbuterol is a β2-agonist approved in the United States for veterinary use in nonfood animals. Clenbuterol use is emerging among bodybuilders and fitness enthusiasts attracted to the hypertrophic and lipolytic effects.
  
  
  METHODS
  This was a retrospective chart review of clenbuterol exposures reported to 2 poison control centers. Misuse of clenbuterol for weight loss and bodybuilding was reported in 11 of 13 clenbuterol users. Reported clinical effects included tachycardia, widened pulse pressure, tachypnea, hypokalemia, hyperglycemia, ST changes on electrocardiogram (ECG), elevated troponin, elevated creatine phosphokinase (CPK), palpitations, chest pain, and tremor. Measured serum clenbuterol concentration was 2983 pg/mL post 4.5 mg ingestion. Co-ingestants included T3 and anabolic steroids. Treatments included activated charcoal, benzodiazepines, β-blockers, potassium replacement, and intravenous (IV) fluid.
  
  
  CONCLUSIONS
  There is an increasing use of the Internet for illicit drug use for bodybuilding and weight loss purposes. These patients may not present as the stereotype of illicit drug abusers, but as healthy athletic low-risk patients. Clinical effects persisted greater than 24 hours with evidence of myocardial injury in 2 patients. Clenbuterol is increasingly being abused within the bodybuilding subculture. These cases illustrate the hidden dangers of clenbuterol abuse among bodybuilders and fitness enthusiasts.
authors.affiliation: Central Ohio Poison Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. henry.spiller@nationwidechildrens.org
authors.forename: Henry A
authors.initials: HA
authors.lastname: Spiller
authors.forename: Kyla J
authors.initials: KJ
authors.lastname: James
authors.forename: Steven
authors.initials: S
authors.lastname: Scholzen
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Borys
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000506:poisoning*; D000328:Adult; D002675:Child, Preschool; D002976:Clenbuterol / Q000008:administration & dosage / Q000506:poisoning*; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning; D008297:Male; D008875:Middle Aged; D058573:Performance-Enhancing Substances / Q000008:administration & dosage / Q000506:poisoning*; D010809:Physical Fitness; D011039:Poison Control Centers; D012651:Self Medication / Q000009:adverse effects*; D015431:Weight Loss / Q000187:drug effects
chemical_list: D000318:Adrenergic beta-Agonists; D013287:Illicit Drugs; D058573:Performance-Enhancing Substances; D002976:Clenbuterol