Propylhexedrine (Benzedrex): Some things old are new again
The bottom line
Propylhexedrine (Benzedrex) inhalers can be bought without a prescription for use as a nasal decongestant but can be abused to stay alert or to get high. They should not be used for these purposes.
Prevention Tips
Propylhexedrine (Benzedrex) inhalers are easier to get than other substances of abuse.
Talk to teens about potential dangers of drugs, even those that can be purchased legally.
This Really Happened
A college student called a poison center because she had been unable to go to sleep all night. At 10 pm the day before, she swallowed the contents of a Benzedrex inhaler to help her study. She did not have a history of heart problems but was having palpitations and was not feeling well. The poison center recommended that she go to an ER to be evaluated since propylhexedrine ingestions have caused heart rhythm changes and deaths. The poison center called the ER to let them know the patient was coming and what to expect.
In the ER, her pulse was elevated. She was given IV fluids and a sedative. A few hours later, the poison center called to check on the patient. Her heart rate was still a bit high, but she was feeling better. She was allowed to go home later that day.
The Full Story
Benzedrex inhalers are nonprescription products containing propylhexedrine. They are intended to provide temporary relief of nasal congestion by constricting blood vessels in the nose.
Propylhexedrine was developed as a substitute for amphetamine - once the active ingredient in Benzedrex inhalers. This change was made over 60 years ago in response to abuse and deaths from amphetamine extracted from the inhalers. While propylhexedrine is related to amphetamine, it has been structurally modified to be less dangerous. Benzedrex inhalers can be legally purchased, but propylhexedrine abuse occurs as people try to find legal ways to get high or increase productivity and concentration. People who abuse propylhexedrine report that while energy, anxiety, and heart rate definitely increase, productivity does not. Many also report a bad “crash” after it wears off.
There have been many reports of toxicity associated with propylhexedrine extracted from an inhaler and swallowed or injected. Swallowing the contents of one propylhexedrine inhaler has caused heart attack and lung injury in adults and children. One form of propylhexedrine abuse is called “parachuting”, “bombing”, or “dropping, and involves wrapping the components of the inhaler in tissue paper in attempt to avoid the bad taste associated with swallowing the medication. This form of abuse increases the risk of overdose as well as injury to the gastrointestinal system.
Propylhexedrine toxicity can take many forms. In general, healthcare providers worry about increased heart rate and blood pressure, which can last for a long time and potentially cause changes in heart rhythm. Propylhexedrine causes constriction of blood vessels, which blocks one of the body’s natural cooling mechanisms. People abusing drugs like propylhexedrine are at risk of overheating and dehydration. Lung injury is thought to result from the high blood pressure. Toxic effects have been reported with one-time use as well as chronic use.
If you have questions about propylhexedrine abuse or think that someone might be having problems from using propylhexedrine, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
