Carboxyatractyloside poisoning causes multiple organ dysfunction and can be fatal, the signs of a poor prognosis including coagulation abnormalities, hyponatraemia, marked hypoglycaemia, icterus and hepatic and renal failure, without antidote. Carboxyatractyloside can induce permeability transition, and that ageing induced mitochondrial DNA disruption and release of cytochrome c; it induces the inhibitory effect of tamoxifen on nonspecific membrane permeability.