Pharmaceuticals
Many modern pharmaceuticals (e.g. Prozac, Paxil) contain “organofluorines.” An organofluorine is a chemical compound that contains both carbon and fluorine. The fact, however, that a pharmaceutical is made with an organofluorine does not mean that it will increase your exposure to fluoride. This is because the fluorine in the drug forms a very strong bond with the carbon and this bond resists metabolizing into fluoride ion. It is generally believed, therefore, that most organofluorine drugs do not contribute to daily fluoride exposure.
There are some organofluorine drugs, however, that do metabolize into fluoride. This is evident by studies finding elevated levels of fluoride showing up in the urine or blood following use of the drug. Because organofluorine drugs contain high quantities of fluorine, any drug that metabolizes into fluoride will likely be a very large source of daily exposure. Drugs that are known to break down into fluoride ion include: fluorinated anesthetics, Cipro, Niflumic acid, Flecainide, and Voriconazole. It is possible, and indeed likely, that other drugs do so as well, but have not yet been discovered.
The following are a list of studies documenting inorganic fluoride exposure from the use of organofluorine drugs:
Anesthetics (Isoflurane, Sevoflurane)
Hoemberg M, et al. (2012). Plasma fluoride concentrations during prolonged administration of isoflurane to a pediatric patient requiring renal replacement therapy. Paediatric Anaesthia 22(4):412-3.
Oc B, et al. (2012). The effects of sevoflurane anesthesia and cardiopulmonary bypass on renal function in cyanotic and acyanotic children undergoing cardiac surgery. Renal Failure 34(2):135-41.
Cipro:
Pradhan KM, et al. (1995). Safety of ciprofloxacin therapy in children: magnetic resonance images, body fluid levels of fluoride and linear growth. Acta Paediatrica 84(5):555-60.
Flecainide:
Rimoli CN, et al. (1991). Relationship between serum concentrations of flecainide and fluoride in humans. Boll. Chim. Farmaceutico 130(7):279-82.
Niflumic Acid:
Gras-Champel V, et al. (2003). [Chronic fluorine intoxication during prolonged treatment with niflumic acid]. [Article in French] Presse Med. 2003 Jun 7;32(20):933.
Welsch M, et al. (1990). [Iatrogenic fluorosis. 2 cases]. [Article in French] Therapie. 45(5):419-22.
Meunier PJ, et al. (1980). Niflumic acid-induced skeletal fluorosis: iatrogenic disease or therapeutic perspective for osteoporosis? Clin Orthop Relat Res. 148:304-9.
Prost A, et al. (1978). [Fluorine osteosis caused by a very long-term niflumic acid treatment in 2 cases of rheumatoid arthritis]. [Article in French] Rev Rhum Mal Osteoartic. 45(12):707-16.
Voriconazole
Wermers RA, et al. (2011). Fluoride excess and periostitis in transplant patients receiving long-term voriconazole therapy. Clinical Infectious Diseases 52(5):604-11.
Chen L, Milligan ME. (2011). Medication-induced periostitis in lung transplant patients: periostitis deformans revisited. Skeletal Radiology 40:143-48.
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