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Human & Experimental Toxicology
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Pharmacokinetics and Toxic Effects of Diltiazem in Massive Overdose

R.E. Ferner

Regional Clinical Pharmacology Unit Freeman Hospital, Newcastle upon Tyne NE7 7DN

O. Odemuyiwa

Department of Cardiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN

A.B. Field

Regional Clinical Pharmacology Unit Freeman Hospital, Newcastle upon Tyne NE7 7DN

S. Walker

Poisons Unit, New Cross Hospital, London SE14 5ER, UK

G.N. Volans

Poisons Unit, New Cross Hospital, London SE14 5ER, UK

D.N. Bateman

Regional Clinical Pharmacology Unit Freeman Hospital, Newcastle upon Tyne NE7 7DN

A 50-year-old man with ischaemic heart disease took 98 tablets of diltiazem 60 mg with alcohol. He developed a junctional bradycardia, hypotension and reduced cardiac function refractory to intravenous calcium gluconate. He survived with temporary cardiac pacing and infusion of dopamine. As much as half the dose was vomited back, but nonetheless the plasma diltiazem concentration reached 6090 µg/l before falling mono-exponentially with a half-life of 8.6 h. Sinus rhythm returned when the plasma concentration of diltiazem was around 750 µg/l. Standard resuscitative procedures sufficed to treat massive diltiazem overdosage.

Human & Experimental Toxicology, Vol. 8, No. 6, 497-499 (1989)
DOI: 10.1177/096032718900800611
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