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Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia.
Institute active cardiac and respiratory monitoring during massive overdose. Frequent blood pressure measurements are necessary. Initiate cardiovascular support (i.e., elevation of extremities, judicious administration of fluids) if hypotension occurs. If hypotension remains unresponsive to these conservative measures, administration of vasopressors such as phenylephrine should be considered with attention to circulation volume and urine output. Intravenous calcium gluconate may help reverse the effects of calcium entry blockade. Hemodialysis is not likely to be of benefit since amlodipine is highly protein bound.
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