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Patients with overdosage may experience effects which are reversible with supportive care including lethargy, drowsiness, nausea, vomiting, epigastric pain; gastrointestinal bleeding may occur. Severe cases such as acute renal failure, hepatic dysfunction, respiratory depression, convulsion, cardiovascular failure, cardiac arrest, anaphylactoid reaction, may occur.
Symptomatic and supportive care are recommended. For acute overdosage, gastric lavage is suggested within 1 hour after overdosage, followed by activated charcoal within 1-2 hours; repeat administration may be useful following substantial overdose or those with severe symptoms. It is also suggested to take cholestyramine orally 4 g 3 times a day to accelerate the drug removal.
Forced diuresis, alkalinization of urine, hemodialysis or hemoperfusion may not be useful due to high protein binding.
