2015 年 41 巻 5 号 p. 342-346
We report a case study of a patient with diarrhea caused by the additive D-sorbitol in a commercialized product, acetaminophen syrup. The patient was a man in his seventies diagnosed with laryngeal cancer (right glottic poorly differentiated squamous cell carcinoma, cT4aN2M1 Stage C). He had been treated with acetaminophen syrup to alleviate the pain in his throat caused by radiation therapy for his laryngeal cancer. Immediately after administration of the acetaminophen syrup, he suffered from diarrhea. This medication was discontinued and replaced by acetaminophen granules and his diarrhea disappeared. The package insert for the acetaminophen formulation dispensed in Japan reads as follows: “Abdominal pain and diarrhea may be seen as side effects associated with high doses of acetaminophen. There is a risk that this side effect may not be distinguished from the gastrointestinal symptoms associated with upper respiratory infection, therefore this medication should be administered with care with careful patient observation.” In this case, we found that the cause of the side effect diarrhea was highly likely to be the additive ingredient D-sorbitol. This side effect may depend on the age and condition of the patient but should be considered when choosing acetaminophen syrup formulations.