Licorice Poisoning Treatment & Management

Updated: Apr 23, 2019
  • Author: Seth Schonwald, MD, FACEP; Chief Editor: Sage W Wiener, MD  more...
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Treatment

Approach Considerations

Prehospital care consists of supportive treatment, including airway, breathing, and circulatory support (ABCs), as clinically indicated. Cardiac monitoring should be performed if clinically indicated.

Emergency department care is as follows:

  • Toxicity typically develops after chronic excessive ingestion; most patients with a single acute ingestion will not develop toxicity
  • In cases of suspected chronic toxicity, monitor electrolytes, especially potassium
  • Supplement potassium, as indicated
  • Consider potassium-sparing diuretics, as needed
  • Treat rhabdomyolysis, if present, with hydration
  • Monitor for and treat electrolyte-induced dysrhythmias.
  • Monitor for and treat pulmonary edema and respiratory muscle weakness

Consider admitting patients with any of the following:

  • Severe electrolyte abnormalities
  • Symptomatic hypokalemia, especially if electrocardiographic changes are present (eg, prolonged QT)
  • Severe or symptomatic hypertension
  • Progressive weakness or paralysis
  • Rhabdomyolysis
  • Pulmonary edema

Consultations with an endocrinologist and a toxicologist may be helpful. Frequent assessment of hypertension and hypokalemia, as well as the need for further potassium supplements and diuretics, may be included in outpatient care.

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Prevention

Avoiding ingestion of natural licorice in the following settings is reasonable:

  • Hypertension
  • Diuretic use
  • Sexual dysfunction
  • Pregnancy 
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