Editing Cantharidin (section)

==Human medical issues==

===General risks===
As a blister agent, cantharidin has the potential to cause adverse effects when used medically; for this reason, it has been included in a list of "problem drugs" used by dermatologists and emergency personnel.<ref name="karras-1996">{{cite journal | vauthors = Karras DJ, Farrell SE, Harrigan RA, Henretig FM, Gealt L | title = Poisoning from "Spanish fly" (cantharidin) | journal = The American Journal of Emergency Medicine | volume = 14 | issue = 5 | pages = 478–483 | date = September 1996 | pmid = 8765116 | doi = 10.1016/S0735-6757(96)90158-8 | quote = While most commonly available preparations of Spanish fly contain cantharidin in negligible amounts, if at all, the chemical is available illicitly in concentrations capable of causing severe toxicity. Symptoms of cantharidin poisoning include burning of the mouth, dysphagia, nausea, hematemesis, gross hematuria, and dysuria. Mucosal erosion and hemorrhage is seen in the upper gastrointestinal (GI) tract. Renal dysfunction is common and related to acute tubular necrosis and glomerular destruction. }}</ref> However, this references unregulated sources of cantharidin.<ref name="Binder-1979"> {{cite journal | vauthors = Binder R | title = Malpractice--in dermatology | journal = Cutis | volume = 23 | issue = 5 | pages = 663–666 | date = May 1979 | pmid = 456036 }}</ref> In July 2023, the US FDA approved a topical formulation of cantharidin (Ycanth) for the treatment of [[molluscum contagiosum]].<ref name = "FDA_2023" />

When [[ingestion|ingested]] by humans, the {{LD50}} is unknown, but fatal doses have been 
recorded between 10 mg and 65 mg.<ref>{{cite journal | url=https://jamanetwork.com/journals/jamadermatology/fullarticle/478535 | doi=10.1001/archderm.137.10.1357 | title=Cantharidin Revisited | date=2001 | journal=Archives of Dermatology | volume=137 | issue=10 | pages=1357–1360 | pmid=11594862 | vauthors = Moed L, Shwayder TA, Chang MW }}</ref> The median lethal dose appears to be around 1 mg/kg<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/14428136/ | pmid=14428136 | date=1960 | vauthors = Oaks WW, DiTunno JF, Magnani T, Levy HA, Mills LC | title=Cantharidin poisoning | journal=Archives of Internal Medicine | volume=105 | issue=4 | pages=574–582 | doi=10.1001/archinte.1960.00270160072009 }}</ref> but individuals have survived after consuming oral doses as high as 175 mg.<ref>{{cite journal | url=https://pubs.acs.org/doi/10.1021/jf00077a045 | doi=10.1021/jf00077a045 | title=Endothal and cantharidin analogs: Relation of structure to herbicidal activity and mammalian toxicity | date=1987 | journal=Journal of Agricultural and Food Chemistry | volume=35 | issue=5 | pages=823–829 | bibcode=1987JAFC...35..823M | vauthors = Matsuzawa M, Graziano MJ, Casida JE }}</ref> Ingesting cantharidin can initially cause severe damage to the lining of the [[Gastrointestinal tract|gastrointestinal]] and [[Urinary system|urinary tracts]], and may also cause permanent [[renal]] damage. Symptoms of cantharidin poisoning include [[hematuria]], abdominal pain, and (rarely) [[priapism]].<ref name="Binder-1979" />

===Risks of aphrodisiac use===
{{main|Lytta vesicatoria}}
The extreme toxicity of cantharidin makes any use as an aphrodisiac highly dangerous.<ref name=shamloul-2010>{{cite journal | vauthors = Shamloul R | title = Natural aphrodisiacs | journal = The Journal of Sexual Medicine | volume = 7 | issue = 1 Pt 1 | pages = 39–49 | date = January 2010 | pmid = 19796015 | doi = 10.1111/j.1743-6109.2009.01521.x }}</ref><ref name=sandroni-2001>{{cite journal | vauthors = Sandroni P | title = Aphrodisiacs past and present: a historical review | journal = Clinical Autonomic Research | volume = 11 | issue = 5 | pages = 303–307 | date = October 2001 | pmid = 11758796 | doi = 10.1007/BF02332975 | quote = Cantharidin ("Spanish fly") is a chemical with vesicant properties derived from blister beetles, which has been used for millennia as a sexual stimulant by both sexes. Its mode of action is by inhibition of phosphodiesterase and protein phosphatase activity and stimulation of β-receptors, inducing vascular congestion and inflammation. Morbidity from its abuse is significant. The gastrointestinal tract sustains the brunt of toxicity, resulting in fatal hemorrhages. Renal toxicity is a result of its renal excretion, which may lead to acute tubular necrosis. Cardiac effects are most likely due to hemorrhagic shock, but they also can be due to myofibril degeneration, mitochondrial swelling, and pericardial and subendocardial hemorrhages. | s2cid = 32348540 }}</ref>  As a result, it is illegal to sell (or use) cantharidin or preparations containing it without a prescription in many countries.<ref name=karras-1996/>