When is inpatient evaluation indicated in the treatment of calcium channel blocker (CCB) toxicity?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Answer

Inpatient evaluation is indicated for patients who have ingested calcium blockers above a certain amount. [24] See Table 1, below. Co-ingestants must be taken into account; these amounts assume isolated unintentional ingestion of only the calcium-blocking med.ication

Table. Recommendations for In-hospital Evaluation Based on Drug and Dosage of Calcium Channel Blocker Ingested (Open Table in a new window)

Drug

Adult Dosage

Pediatric Dosage

Amlodipine

>10 mg

>0.3 mg/kg

Diltiazem

>120 mg immediate-release formulation; >360 mg sustained_release formulation

>1 mg/kg

Felodipine

>10 mg

>0.3 mg/kg

Isradipine

>20 mg

>0.1 mg/kg

Nicardipine

>40 mg immediate release; >60 mg sustained-release

>1.25 mg/kg

Nifedipine

>30 mg immediate-release; >120 mg sustained-release

Any amount

Nimodipine

>60 mg

Any amount

Nisoldipine

>30 mg

Any amount

Verapamil

>120 mg immediate-release; >480 mg sustained-release

>2.5 mg/kg


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