Vasoten Overdosage

If overdose occurs, bisoprolol treatment should be stopped. Supportive therapy and symptomatic treatment should be provided. Limited data suggest bisoprolol fumarate cannot be dialysed.
Symptoms of overdose with a beta-blocker may include bradycardia, hypotension, bronchospasm and acute cardiac insufficiency. Bradycardia or extensive vagal reactions may be countered by atropine.
Hypotension and shock may be treated with intravenous fluids, and, if necessary, catecholamines. The beta-blocking effect may be counteracted by slow intravenous administration of isopranaline or dobutamine. In refractory cases, isopranaline may be combined with dopamine. If this does not produce the desired effect, intravenous glucagon may be considered. The administration of calcium ions or the use of a cardiac pacemaker may also be considered.
AV block (second or third degree): Patients should be carefully monitored and treated with isoprenaline or cardiac pacemaker insertion, as appropriate.
Acute worsening of heart failure: Administration of intravenous diuretics and inotropic agents should be considered.
Bronchospasm can usually be reversed by intravenous bronchodilators.