A batch of cough syrup gets distributed. Labels look fine. Dosage seems standard. But inside? A toxic industrial solvent. That’s how diethylene glycol (DEG) entered the conversation and the bloodstream of unsuspecting patients.
Let’s unpack how this happens, and why it matters.
What Is Diethylene Glycol?
DEG is a colorless, odorless chemical used in antifreeze, brake fluids, and plastics. It’s cheap, widely available, and not approved for pharmaceutical use. Yet it sometimes replaces safer excipients like glycerin or propylene glycol either by mistake or cost-cutting.
How Does It Slip Into Medicines?
- Substitution at source: Industrial-grade solvents get mislabeled or swapped for pharma-grade ones.
- Lack of excipient testing: Manufacturers skip full-spectrum analysis of raw materials.
- Weak oversight: Regulatory gaps allow contaminated batches to pass through.
- Supply chain blind spots: Distributors and pharmacies trust the label, not the lab.
This isn’t just a manufacturing error it’s a breakdown across the system.
Why Is DEG So Dangerous?
Once ingested, DEG is metabolized into toxic compounds that damage:
- Kidneys → leading to acute renal failure
- Liver → disrupting metabolic pathways
- Nervous system → causing confusion, seizures, and coma
Children are especially vulnerable. Even small doses can be fatal.
What This Means for Healthcare Organizations
- Audit excipients, not just APIs
- Enforce batch-level testing for OTC syrups
- Educate frontline staff on red flags
- Report adverse events promptly and transparently
Pharmacovigilance isn’t just post-marketing it starts at sourcing.
And the final take home message is 
DEG contamination isn’t rare it’s recurring. From Panama to Gambia to India, the pattern is clear.
The question is: how do we stop it from happening again?
MBH/AB