ToxicologyEmergencyCardiology
Calcium channel blocker overdose
Calcium, high-dose insulin euglycaemia and intralipid for severe calcium-channel-blocker poisoning.
Source: TOXBASE/NPIS; AACT/EAPCCT; ESC; BNF
Step 1 of ~6
warning
Highly lethal overdose
Non-dihydropyridines (verapamil, diltiazem) → bradycardia, AV block, severe hypotension. Dihydropyridines (amlodipine, nifedipine) → severe vasoplegic shock with reflex tachycardia.
ABCDE; ITU referral; arterial line; central access if shocked.
Bloods: VBG (lactate, glucose — typically high), U&E, troponin, ionised calcium. ECG.
Decontamination: activated charcoal within 1 h; whole-bowel irrigation for SR/MR products after NPIS advice.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Calcium Gluconate 10%RecommendedElectrolyte
- GlucagonRecommendedHypoglycaemia Antidote / Endocrine Agent
- AmlodipineRecommendedDihydropyridine Calcium Channel Blocker
- VerapamilRecommendedNon-Dihydropyridine Calcium Channel Blocker
- DiltiazemRecommendedNon-Dihydropyridine Calcium Channel Blocker
Same class
Pathways
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014); BNF
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Opioid overdose · TOXBASE/NPIS; Resuscitation Council UK; BNF
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT; BNF
- Benzodiazepine overdose · TOXBASE/NPIS; AACT/EAPCCT; BNF
- β-blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC; BNF
Decision support only. Always apply local guidelines and clinical judgement.