The shock death of a promising track star teenager from a seemingly innocuous muscle cream, has put the spotlight on the safety of over-the counter drugs.
Arielle Newman, 17, from Notre Dame Academy on Staten Island died April 3, from an overdose of the muscle cream BenGay, which contains the active ingredient methyl salicylate. Such muscle creams are used very commonly to soothe aching muscles after training sessions of sports.
Says Dr. Gerard Varlotta, director of sports rehabilitation at the Rusk Institute of Rehabilitation Medicine at New York University Medical Center: "There has to be a heightened awareness that these products are something that needs to be used under medical supervision."
Experts now are pointing to a need for clearer warnings about risks, especially because muscle creams have become a staple in locker rooms around the country.
According to Ellen Borakove, a spokeswoman for the medical examiner, Newman put the muscle cream on her legs and used adhesive pads containing the anti-inflammatory, plus an unspecified third product. "These were multiple products, used to great excess, and that's how she ended up with high levels," says Borakove. The products were used and the chemical absorbed over time, rather than from a single instance of overuse, she added.
The warning labels on most muscle creams say to stop using them if "condition worsens or symptoms persist for more than 7 days." The labels also say to keep the products out of the reach of children.
Says Dr. Thomas Kearney, who directs a poison control center and is a professor of pharmacy at the University of California at San Francisco: "It's on my one-swallow-to-kill list for kids".
Kearney adds that topical application of methyl salicylate can be hazardous, if it is smeared over 40 percent of the body, if someone has a skin condition or if another medication interacts negatively with the products.
According to Kimberley Rawlings, a spokeswoman for the FDA, the agency is aware of Newman's death. "We are looking into it," she says. Yet, she declined to comment whether the labeling requirements for methyl salicylate products might be changed.
Experts say that methyl salicylate is not the only common pain reliever that can be dangerous if used improperly. Accidental poisonings from acetaminophen, best known by the Tylenol brand, are the nation's leading cause of acute liver failure.
Opines Rebecca Burkholder, vice president for health policy at the National Consumers League: "A big problem is that people don't read warning labels on over-the-counter drugs. People are thinking if it's on the shelf at their local drugstore that it's harmless.
"And they're going to take as much as they need to make the pain go away", she warns.