Signs and Symptoms of Overdose: There are no reports found in the literature describing the overdose potential of the combination ammonium chloride and diphenhydramine hydrochloride (with or without sodium citrate).
The information presented as follows describes overdose with the single active ingredients.
Ammonium chloride: Overdose from oral formulation has been reported in medical literature. In these cases, overdose resulting in metabolic acidosis occurred in the setting of prolonged intake of ammonium chloride above the recommended dose and/or renal impairment. From these reports, symptoms of metabolic acidosis ma include headache, generalized muscle weakness, hyperventilation, hyper-reflexia, progressive drowsiness, mental confusion and coma.
Diphenhydramine: Mild to Moderate Symptoms: Somnolence, anticholinergic syndrome (mydriasis, flushing, fever, dry mouth, urinary retention, decreased bowel sounds), tachycardia, mild hypertension, nausea and vomiting are common after overdose. Agitation, confusion and hallucinations may develop with moderate poisoning.
Severe Symptoms: Effects may include delirium, psychosis, seizures, coma. hypotension, QRS widening, and ventricular dysrhythmias, including torsades de pointes, but are generally only reported in adults after large ingestions. Rhabdomyolysis and renal failure may rarely develop in patients with prolonged agitation, coma or seizures. Death may occur as a result of respiratory failure or circulatory collapse.
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