Carvedilol overdose with quantitative confirmation

Basic Clin Pharmacol Toxicol. 2008 Jul;103(1):102-3. doi: 10.1111/j.1742-7843.2008.00269.x.

Abstract

Carvedilol is a non-selective beta-adrenoreceptor antagonist that is also an antagonist at the alpha(1)-adrenoreceptor. This unique pharmacological effect may produce a different toxicodynamic profile compared to other beta-adrenoreceptor antagonists. Only one previous case of carvedilol overdose has been reported. Here, we report massive carvedilol ingestion confirmed by quantitative analysis. The case report deals with an 84-year-old man who chewed a total of 60 (6.25 mg) tablets and rapidly developed symptoms. Vital signs on presentation were systolic blood pressure 70 mmHg; heart rate 45 beats/min.; respirations 18 breaths/min.; temperature 37 degrees . The electrocardiogram showed a junctional rhythm at 49 beats/min. The patient was treated with normal saline boluses, repeated glucagon boluses (2-3 mg each) and a dopamine infusion. At 14 hr after ingestion, he was weaned off vasopressors and was in a normal sinus rhythm. Quantitative confirmation showed a carvedilol serum concentration of 472 ng/ml (steady-state concentration 8.5 ng/ml during 6.25 mg twice daily dosing). Despite its unique pharmacological properties, the clinical manifestations of carvedilol overdose appear similar to other beta-adrenoreceptor antagonists.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic alpha-Antagonists / poisoning*
  • Adrenergic beta-Antagonists / poisoning*
  • Aged, 80 and over
  • Carbazoles / poisoning*
  • Carvedilol
  • Dopamine / therapeutic use
  • Drug Overdose
  • Glucagon / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Male
  • Propanolamines / poisoning*

Substances

  • Adrenergic alpha-Antagonists
  • Adrenergic beta-Antagonists
  • Carbazoles
  • Propanolamines
  • Carvedilol
  • Glucagon
  • Dopamine