Symptoms and signs: The principal toxic effect is bone marrow suppression, leading to leucopenia, thrombocytopenia and anaemia.
Tab: Gastrointestinal effects, including nausea, vomiting and diarrhoea are the most likely early signs of acute oral overdosage.
Inj: The immediate effects of acute intravenous overdosage are nausea and vomiting. Damage to the gastrointestinal mucosa may also ensue, and diarrhoea, sometimes haemorrhagic, has been reported after overdosage.
Treatment: General supportive measures, together with appropriate blood and platelet transfusions, should be instituted if necessary and consideration given to hospitalisation, cover with anti-infective agents, and the use of haematological growth factors.
There is no specific antidote. The blood picture should be closely monitored for at least 4 weeks following overdosage until there is evidence of recovery.