Four years ago, when seven people in the Chicago area died after taking cyanide-laced capsules of Tylenol pain reliever, the crime seemed so horrible --so peculiarly horrible--that it was hard to believe it would ever be repeated. And yet it has been, again and again. Last February tainted Tylenol capsules killed a Peekskill, N.Y., woman. A month later traces of rat poison were found in Contac cold capsules and Teldrin allergy medication in Houston and Orlando. Two weeks ago, medical investigators discovered that two residents of Auburn, Wash., had died as a result of swallowing toxic Excedrin capsules. Bristol-Myers quickly pulled Excedrin capsules off the market nationwide, but last week Auburn's cyanide scare spread to yet another brand of pain-killer. During a random check of a pharmacy in the Seattle suburb, Food and Drug Administration officials found poisoned capsules of Anacin-3, made by American Home Products. Within a day, the State of Washington imposed a 90-day ban on the sale of most nonprescription capsule drugs.
Manufacturing over-the-counter capsules has been a fast-growing, profitable business (1985 sales: $1.5 billion), but the market is suddenly shrinking. Within the past five months, both Bristol-Meyers and Johnson & Johnson, the maker of Tylenol, have stopped selling any of their nonprescription drugs in capsule form. While most other manufacturers insist that they have no current intention of walking away from this market, consumers and producers across the U.S. are pondering the uncertain fate of the still popular product.
Thousands of different kinds of nonprescription capsules continue to be sold today. In all, Americans bought about 10.5 billion doses of these gelatin-cased medications last year. Among the leading brands: Contac (made by SmithKline Beckman), and Sinutab and Benadryl (both made by Warner-Lambert). Nearly all over-the-counter drugs are two-piece capsules, although the single- piece model, used for some vitamins, is perhaps safer. If anyone were to try ; to pierce a single-piece shell, it would probably leak and be very difficult to seal again. In tampering with two-piece capsules, a criminal might be able to separate the two parts, contaminate the medication and later put the pieces back together. So far, though, single-piece capsules can hold only liquid drugs. Reason: the medication cannot pass through the special machinery used to make single-piece capsules unless it is in liquid form. Most over-the-counter medication comes in powder or solid-pellet form.
When the first deaths from capsule poisonings were reported, companies said they would be developing tamper-resistant products. In the beginning, manufacturers focused on making the outside of the packaging more secure. For example, they placed tightly sealed plastic around the tops of the bottles. Later came other ideas. R.P. Scherer, a capsule manufacturer, developed a "soniseal" machine that uses sonic waves to weld the two pieces of a capsule together. Eli Lilly last year made available to U.S. manufacturers a similar technique. A band of gelatin is placed around the waist of the capsule, where the two pieces overlap. That makes it tougher to open the casing without leaving a mark. But companies were slow to adopt the new technology, apparently because they thought that sealing the pill bottles was sufficient protection.