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Human & Experimental Toxicology
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Pharmacokinetics of verapamil in overdose

Kari T Kivist�

Department of Clinical Pharmacology, University of Helsinki, Haartmaninkatu 4, Fin-00290 Helsinki

Pertti J Neuvonen

Department of Clinical Pharmacology, University of Helsinki, Haartmaninkatu 4, Fin-00290 Helsinki

Leo Tarssanen

Mikkeli Central Hospital, Mikkeli, Finland

The information on the pharmacokinetics of verapamil in overdose is scanty. We report two adults who ingested 3.2 g and 4 g ofverapamil, respectively. Both patients had hypotension and a severe bradycardia. The highest plasma verapamil concentration in these patients was about 2200 ng/ml and 2700 ng/ml, respectively. The decline in plasma verapamil and norverapamil concen trations followed first-order kinetics, and the half-life of verapamil was 7.8 h and 15.1 h, respectively. The free fraction of verapamil (non-protein bound) was higher at total concentrations exceeding 2000 ng/ml (12 -15%) than at lower concentrations (2-6%). There seems to be no marked saturation ofthe metabolism of verapamil in acute poisoning. The apparent concentration-dependent changes in the free fraction may be due to therapeutic measures.

Key Words: verapamil • overdose • pharmacokinetics

Human & Experimental Toxicology, Vol. 16, No. 1, 35-37 (1997)
DOI: 10.1177/0960327197016001071
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