Tamsoli Overdosage

Symptoms: Overdosage with the combination of tamsulosin and solifenacin can potentially result in severe anticholinergic effects plus acute hypotension. The highest dose taken accidentally during a clinical study corresponded to 126 mg of solifenacin succinate and 5.6 mg of tamsulosin hydrochloride. This dose was well-tolerated, with mild dry mouth for 16 days as the only reported adverse event.
Treatment: In the event of overdose with solifenacin and tamsulosin, the patient should be treated with activated charcoal. Gastric lavage is useful if performed within 1 hour, but vomiting should not be induced.
As for other anticholinergics, symptoms of overdose due to the solifenacin component can be treated as follows: Severe central anticholinergic effects such as hallucinations or pronounced excitation: treat with physostigmine or carbachol.
Convulsions or pronounced excitation: treat with benzodiazepines.
Respiratory insufficiency: treat with artificial respiration.
Tachycardia: treat symptomatically if needed. Beta-blockers should be used with caution, since the concomitant overdose with tamsulosin could potentially induce severe hypotension.
Urinary retention: treat with catheterisation.
As with other antimuscarinics, in case of overdosing, specific attention should be paid to patients with a known risk for QT-prolongation (i.e., hypokalaemia, bradycardia and concurrent administration of medicinal products known to prolong QT-interval) and relevant pre-existing cardiac diseases (i.e., myocardial ischaemia, arrhythmia, congestive heart failure).
Acute hypotension, which can occur after overdosage due to the tamsulosin component, should be treated symptomatically. Hemodialysis is unlikely to be of help as tamsulosin is very highly bound to plasma proteins.