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Overdosage experience with oral diltiazem has been limited. Single oral doses of 300 mg have been well tolerated by healthy volunteers. In the event of overdosage or exaggerated response, appropriate supportive medical care should be employed in addition to gastric lavage.
The following measures may be considered.
Bradycardia: Administer atropine (0.60-1.0 mg); if there is no response to vagal blockade, cautiously administer isoproterenol.
High-Degree AV Block: Treat as for bradycardia as previously mentioned; fixed high-degree AV block should be treated with cardiac pacing.
Cardiac Failure: Administer inotropic agents (isoproterenol dopamine or dobutamine) and diuretics.
Hypotension: Administer vasopressors (e.g., dopamine or levarterenol bitartrate).
Actual treatment and dosage should depend on the severity of the clinical situation.
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