Carvedilol overdosage

Carvedilol
COREG®, COREG CR® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Contraindications
Warnings and Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Overdosage
Description
Clinical Pharmacology
Nonclinical Toxicology
Clinical Studies
How Supplied/Storage and Handling
Patient Counseling Information
Labels and Packages

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]

Overdosage

Overdosage may cause severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, and cardiac arrest. Respiratory problems, bronchospasms, vomiting, lapses of consciousness, and generalized seizures may also occur.

• The patient should be placed in a supine position and, where necessary and kept under observation

• The patient should be treated under intensive-care conditions.
• Gastric lavage or pharmacologically induced emesis may be used shortly after ingestion.

The following agents may be administered for excessive bradycardia:

• Atropine, 2 mg IV.

To support cardiovascular function:

• Glucagon, 5 to 10 mg IV rapidly over 30 seconds, followed by a continuous infusion of 5 mg/hour
  
• Sympathomimetics (dobutamine, isoprenaline, adrenaline) at doses according to body weight and effect.

If peripheral vasodilation dominates:

• Administer adrenaline ornoradrenaline with continuous monitoring of circulatory conditions.

For therapy-resistant bradycardia

• pacemaker therapy should be performed.

For bronchospasm

• β-sympathomimetics (as aerosol or IV) or Aminophylline IV should be given.

In the event of seizures

• Administer slow IV injection of diazepam or clonazepam is recommended.

NOTE: In the event of severe intoxication where there are symptoms of shock, treatment with antidotes must be continued for a sufficiently long period of time consistent with the 7-10 hour half-life of carvedilol.

Cases of overdosage with COREG alone or in combination with other drugs have been reported. Quantities ingested in some cases exceeded 1,000 milligrams. Symptoms experienced included low blood pressure and heart rate. Standard supportive treatment was provided and individuals recovered.

References

Adapted from the FDA Package Insert.