Jornal de Toxicologia Clínica
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Fatal Verapamil Intoxication: A Case Report and Literature Review

Thaninee Prasoppokakorn and Suchai Suteparuk

Background: Verapamil intoxication is a life-threatening condition manifesting as hemodynamic instability requiring vasopressor and ventilator supports and even fatal outcome in some patients.

Case report: A 37-year-old female who intentionally took sustained-release verapamil of 3,600 mg, doxazosin of 20 mg, and chlorpheniramine of 40 mg, presented with sudden cardiac arrest. Intubation with cardiopulmonary resuscitation was promptly initiated, and then intravenous calcium gluconate, sodium bicarbonate, and vasopressor were given to maintain hemodynamic condition. During hospitalization, targeted temperature management, temporary cardiac pacing, renal replacement therapy as well as all essential supportive measures were given. However, the patient eventually expired due to refractory cardiogenic shock 4 days after hospitalization. In addition, we review all reported cases of verapamil intoxication in English literature.

Conclusion: We report herein a fatal case of verapamil intoxication, and have a literature review in all reported cases. Hence, verapamil intentional or accidental overdose, can be lethal that requires the prompt initiation of comprehensive resuscitation.