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Overdosage may be associated with bradycardia and hypotension, hyperglycaemia, metabolic acidosis, and coma may also occur.
Supportive and symptomatic care should be given. Hypotension may respond to placing the patient in the supine position with the feet raised. If hypotension is not corrected, calcium should be given intravenously. The usual initial dose is 10 to 20 mL of 10% calcium gluconate given by slow intravenous injection or infusion; alternatively, up to 10 mL of 10% calcium chloride may be given. Glucagon may also be used. If hypotension persists, an intravenous sympathomimetic such as isoprenaline, dopamine, or noradrenaline may also be necessary. Bradycardia may be treated with atropine, isoprenaline, or cardiac pacing.
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