Spedifen Overdosage

Signs and symptoms: Common symptoms of overdose include nausea, vomiting, dizziness, drowsiness, tremors.
Less common are headache, tinnitus, ataxia, tachycardia, miosis and reversible increases in transaminases, bilirubin, and thrombocytopenia.
Severe symptoms are rare and include unconsciousness (coma), metabolic acidosis, seizures, and acute renal insufficiency; also, apnea in children <2 years.
From 400 mg/kg, severe symptoms are possible, although doses up to 60 g can be easily tolerated and doses up to 100 g have not been fatal. In elderly people and small children, those suffering from liver or kidney disease or from chronic alcohol abuse, severe symptoms may be experienced, even at lower doses.
Treatment: From a dose of >200 mg/kg (small child) or 20 g (adult), decontamination with activated charcoal (1 g per kg body weight as aqueous suspension administered once orally). In case of excessive overdose use gastric lavage followed by activated charcoal within 1 hour of intake. Medical monitoring from 300 mg/kg and in all patients at increased risk.
Duration of monitoring: 4 hours, with slow-release preparations 12 hours.
Laboratory tests: Transaminases, creatinine, bilirubin; in symptomatic patients additionally blood gas analysis, electrolytes, platelets.