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Mild to moderate toxicity: Orthostatic hypotension, reflex tachycardia, nausea, vomiting, and dizziness are common; syncope and mild sedation may develop.
Severe toxicity: Hypotension, torsades de pointes, agitation, seizure, and priapism have been reported. Hypotension is generally not life-threatening.
Management of mild to moderate toxicity: Hypotension usually responds to IV fluids.
Management of severe toxicity: Hypotension that does not respond to IV fluids should be treated with adrenergic vasopressors such as phenylephrine or norepinephrine. Intubate patients with significant CNS depression. Treat seizures with benzodiazepines; add propofol or barbiturate if seizure persist or recur.
