Aprovasc Overdosage

SIGNS AND MANAGEMENT OF OVERDOSAGE OR ACCIDENTAL INTAKE: Experience in adults exposed to doses of up to 900 mg/day irbesartan for 8 weeks revealed no toxicity. No specific information is available on the treatment of overdose with irbesartan. Available data for amlodipine suggest that overdose could result in excessive peripheral vasodilatation and possibly reflex tachycardia. Marked and probably prolonged systemic hypotension and shock with fatal outcome have been reported. The patient should be closely monitored and symptomatic and supportive treatment administered.
Suggested measures include gastric lavage. Administration of activated charcoal to healthy subjects immediately or up to two hours after ingestion of amlodipine 10 mg has been shown to significantly decrease amlodipine absorption.
As amlodipine is highly protein bound and irbesartan is not removed from the body by hemodialysis, hemodialysis does not appear to be useful.
If massive overdose should occur, active cardiac and respiratory monitoring should be initiated. Frequent blood pressure measurement is essential. Clinically significant hypotension due to amlodipine overdose calls for active cardiovascular support including elevation of the extremities and attention to circulating fluid volume and urine output. A vasoconstrictor may be helpful in restoring vascular tone and blood pressure, provided that there is no contraindication to its use.
Intravenous calcium gluconate may be beneficial in reversing the effects of calcium channel blockade.