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. 1995 Jun;39(6):680–683. doi: 10.1111/j.1365-2125.1995.tb05729.x

Prolonged half-life of verapamil in a case of overdose: implications for therapy.

C D Buckley 1, J K Aronson 1
PMCID: PMC1365082  PMID: 7654488

Abstract

After an overdose of verapamil (2.4 g) in a 59-year-old man the apparent half-life of verapamil was prolonged (15 h). The most likely mechanism is rate-limiting absorption, although changes in clearance and volume of distribution may contribute. As the elimination half-life of verapamil is increased in overdose, therapy may have to be continued for longer than expected. Moreover since the half-life of absorption of verapamil in overdose may be prolonged, activated charcoal should be given in repeated doses, even if an ordinary-release formulation has been taken.

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Selected References

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  1. Buckley N., Dawson A. H., Howarth D., Whyte I. M. Slow-release verapamil poisoning. Use of polyethylene glycol whole-bowel lavage and high-dose calcium. Med J Aust. 1993 Feb 1;158(3):202–204. [PubMed] [Google Scholar]
  2. Crump B. J., Holt D. W., Vale J. A. Lack of response to intravenous calcium in severe verapamil poisoning. Lancet. 1982 Oct 23;2(8304):939–940. doi: 10.1016/s0140-6736(82)90912-6. [DOI] [PubMed] [Google Scholar]
  3. Doyon S., Roberts J. R. The use of glucagon in a case of calcium channel blocker overdose. Ann Emerg Med. 1993 Jul;22(7):1229–1233. doi: 10.1016/s0196-0644(05)80997-7. [DOI] [PubMed] [Google Scholar]
  4. Freedman S. B., Richmond D. R., Ashley J. J., Kelly D. T. Verapamil kinetics in normal subjects and patients with coronary artery spasm. Clin Pharmacol Ther. 1981 Nov;30(5):644–652. doi: 10.1038/clpt.1981.216. [DOI] [PubMed] [Google Scholar]
  5. Hamann S. R., Blouin R. A., McAllister R. G., Jr Clinical pharmacokinetics of verapamil. Clin Pharmacokinet. 1984 Jan-Feb;9(1):26–41. doi: 10.2165/00003088-198409010-00002. [DOI] [PubMed] [Google Scholar]
  6. Hendren W. G., Schieber R. S., Garrettson L. K. Extracorporeal bypass for the treatment of verapamil poisoning. Ann Emerg Med. 1989 Sep;18(9):984–987. doi: 10.1016/s0196-0644(89)80465-2. [DOI] [PubMed] [Google Scholar]
  7. Hofer C. A., Smith J. K., Tenholder M. F. Verapamil intoxication: a literature review of overdoses and discussion of therapeutic options. Am J Med. 1993 Oct;95(4):431–438. doi: 10.1016/0002-9343(93)90314-f. [DOI] [PubMed] [Google Scholar]
  8. Horowitz B. Z., Rhee K. J. Massive verapamil ingestion: a report of two cases and a review of the literature. Am J Emerg Med. 1989 Nov;7(6):624–631. doi: 10.1016/0735-6757(89)90287-8. [DOI] [PubMed] [Google Scholar]
  9. Kates R. E., Keefe D. L., Schwartz J., Harapat S., Kirsten E. B., Harrison D. C. Verapamil disposition kinetics in chronic atrial fibrillation. Clin Pharmacol Ther. 1981 Jul;30(1):44–51. doi: 10.1038/clpt.1981.125. [DOI] [PubMed] [Google Scholar]
  10. Kenny J. Treating overdose with calcium channel blockers. BMJ. 1994 Apr 16;308(6935):992–993. doi: 10.1136/bmj.308.6935.992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Krick S. E., Gums J. G., Grauer K., Cooper G. R. Severe verapamil (sustained-release) overdose. DICP. 1990 Jul-Aug;24(7-8):705–706. doi: 10.1177/106002809002400711. [DOI] [PubMed] [Google Scholar]
  12. Minella R. A., Schulman D. S. Fatal verapamil toxicity and hypokalemia. Am Heart J. 1991 Jun;121(6 Pt 1):1810–1812. doi: 10.1016/0002-8703(91)90033-e. [DOI] [PubMed] [Google Scholar]
  13. Sauder P., Kopferschmitt J., Dahlet M., Tritsch L., Flesch F., Siard P., Mantz J. M., Jaeger A. Les intoxications aiguës par le vérapamil. A propos de 6 cas. Revue de la littérature. J Toxicol Clin Exp. 1990 Jul-Aug;10(4):261–270. [PubMed] [Google Scholar]
  14. Shand D. G., Hammill S. C., Aanonsen L., Pritchett E. L. Reduced verapamil clearance during long-term oral administration. Clin Pharmacol Ther. 1981 Nov;30(5):701–706. doi: 10.1038/clpt.1981.223. [DOI] [PubMed] [Google Scholar]
  15. Somogyi A., Albrecht M., Kliems G., Schäfer K., Eichelbaum M. Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis. Br J Clin Pharmacol. 1981 Jul;12(1):51–60. doi: 10.1111/j.1365-2125.1981.tb01854.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

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