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Systemic toxicity is manifested by central nervous system excitation such as restlessness, excitement, blurred vision, nausea and vomiting, muscle twitching and in more severe cases, convulsions. Toxicity due to α-adrenergic over stimulation may result in tachycardia and arrhythmia.
Treatment consists of ensuring adequate ventilation and arresting convulsions with intravenous diazepam if required. Cardiac resuscitation may be required to reverse pathologic arrhythmias.
If someone takes a dose larger than the recommended, call a doctor, emergency medical services (EMS), or the nearest poison control center immediately.
