Overdose of sustained-release verapamil

Abstract

Verapamil toxicity results in hypotension, myo-cardial depression and disturbances in cardice conduction. There is no specific therapy available for treatment of verapamil poisoning and management is therefore largely supportive. Overdose of sustained-release verapamil may result in prolonged toxicity which is often delayed in onset. This report describes two patients who ingested large doses of sustained-release verapamil. One patient developed severe toxicity resulting in hypotension and third-degree heart block which persisted for 48 h. In a second patient, significant toxicity was prevented by achieving adequate gastrointestinal decontamination. The mechanisms, presentation and management of verapamil poisoning are discussed. (Br. J.Anaesth. 1994; 72: 361-365). © 1994 Copyright: 1994 British Journal of Anaesthesia.