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KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT: Clinical signs of acute massive overdose usually include a coma, with muscular hypotonia, hyporeflexia, miosis and impaired respiratory functions. Deaths have occurred following massive overdose; nevertheless, a favourable outcome is usual.
Symptoms may however be variable and seizures have been reported in the presence of very high plasma levels. Cases of intracranial hypertension related to cerebral oedema have been reported. Hospital management of overdose should be symptomatic: gastric lavage (which is useful up to 10 to 12 hours following ingestion), cardio-respiratory monitoring, assisted ventilation and other supportive measures are recommended. Haemodialysis and haemoperfusion have been used successfully. Naloxone has been successfully used in a few isolated cases.
