Amlodipine Intoxication: A Different Presentation of Overdose of a Commonly Prescribed Anti-Hypertensive

Abstract

Calcium channel blockers (CCBs) are one of the most commonly prescribed antihypertensive medications in India due to good efficacy and cost-effectiveness. Overdose of this wonderful dihydropyridine though common in the western world has been scarcely reported in the Indian literature. We report the case of intoxication with Amlodipine, in a young female software technician. The patient came with a very different presentation of loose stools with severe hypotension, bradycardia, altered sensorium, hyperglycemia, respiratory distress and metabolic acidosis. With the patient on assisted mechanical ventilation and without any correlating history, there was a diagnostic dilemma. But with detailed history taking and from repeated conversations with the relatives, empty strips of Amlodipine tablets were found at the patient's bedside. The patient was treated with stomach wash, fluid resucsitation, calcium gluconate, Dopamine, hyperinsulinemia euglycemia therapy. The patient made a complete recovery and was discharged after a psychiatric consultation.