Isoptin SR Overdosage

Clinical Manifestations: Hypotension, bradycardia up to high degree AV block and sinus arrest, hyperglycemia, stupor, metabolic acidosis and acute respiratory distress syndrome. Fatalities have occurred as a result of overdose.
Treatment: Treatment of verapamil hydrochloride overdose should be mainly supportive and individualized. Beta adrenergic stimulation and/or parenteral administration of calcium injection (calcium chloride) have been effectively used in treatment of deliberate overdosage with oral verapamil hydrochloride. Clinically significant hypotensive reactions or high-degree AV block should be treated with vasopressor agents or cardiac pacing, respectively. Asystole should be handled by the usual measures including beta adrenergic stimulation (e.g., isoproterenol hydrochloride), other vasopressor agents or cardiopulmonary resuscitation. Due to the potential for delayed absorption of the sustained release product, patients may require observation and hospitalization for up to 48 hours. Verapamil hydrochloride cannot be removed by hemodialysis.