OVERDOSE
The acute oral LD50doses in male and female mice and
male and female rats are over 8000 mg/kg.
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, kept under observation and treated under
intensive-care conditions. Gastric lavge 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, it may be necessary
to administer adrenaline or noradrenaline with continuous
monitoring of circulatory conditions. For therapy-resistant
bradycardia, pacemaker therapy should be performed. For
bronchospasm, b-sympathomimetics (as aerosol or IV) or
aminophylline IV should be given. In the event of seizures,
IV injection of diazepam or clonazepam is recommended.
NOTE: In the event of severe in toxication
where there are symptoms of shock, treatment with antidotes
must be continued for a sufficiently long period of time
consistent with the 7- to 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 1000 milligrams. Symptoms experienced included
low blood pressure and heart rate. Standard supportive treatment
was provided and individuals recovered.
CONTRAINDICATIONS
Coreg is contraindicated in patients with NYHA class
IV decompensated cardiac failure requiring intravenous
inotropic therapy, bronchial asthma (two cases of death
from status asthmaticus have been reported in patients
receiving single doses of Coreg) or related bronchospastic
conditions, second-or third-degree AV block, sick sinus
syndrome (unless a permanent pacemaker is in place), cardiogenic
shock or severe bradycardia.
Use of Coreg in patients with clinically manifest hepatic
impairment is not recommended.
Coreg is contraindicated in patients with hypersensitivity
to the drug. |
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