Jennifer Esch, PharmD, MBA, BCPS; Matthew Bougie, PharmD; Alexis Vandehey, PharmD, BCPS
WMJ. 2026;125(3):424-426. Published August 11, 2026.
ABSTRACT
Introduction: Overdoses due to novel potent opioids continue to increase across the United States. The availability of colored fentanyl products that may appeal to younger patients is concerning.
Case Presentation: We present the case of an adult male with an unknown ingestion subsequently identified as purple fentanyl. Brorphine is a common component of purple fentanyl and is considered an emerging novel potent opioid.
Discussion: Only limited number of case reports describing brorphine exposure are available, and many clinicians remain unfamiliar with this substance. It is a potent opioid with a presumed long half-life. Clinical presentation is similar to that of other opioid toxidromes, including respiratory depression, miosis, and sedation, and is managed similarly. Patients may require extended monitoring after exposure to brorphine.
Conclusions: Awareness of emerging substances of abuse will enable clinicians to diagnose and treat affected patients more readily.