The aim of the present study is to assess the effectiveness of repeated cyclosphosphamide (CP) and methylprednisolone (MP) combination in the treatment of paraquat (PQ) poisoning in a double-blind, randomized clinical trial. Eligible participants in this study are patients with moderate to severe PQ poisoning within 24 hours of hospitalization. Due to the unavailability of equipment to measure serum PQ levels, moderate to severe PQ poisoning is confirmed if urine samples turn dark blue in the urinary sodium dithionite test. Patients will be allocated in a random fashion between case and control groups. The sample size is calculated based on previous studies almost 46 patients. Taking any other poisons, underlying renal, hepatic, and pulmonary diseases, and unconsciousness are considered as exclusion criteria.
All patients receive two cycles of eight hours hemoperfusion with charcoal, and undergo emergency hemodialysis in the fastest time possible. After the dialysis, the intervention group receive 15 mg/Kg CP for two days and 1g MP for three days. Each drug infuses in 200 cc dextrose saline 5 % during two hours. The control group receives routine, supportive care and 200 cc dextrose saline 5% infusion during two hours for three days as placebo. At the time of admission, demographic characteristics, history of underlying diseases, and time between PQ intake and the entrance to the emergency department are recorded. During the study daily measurement of liver function test, renal function test and blood gas are performed. Finally mentioned paraclinic findings and mortality between the two group are compared.