UMEM Educational Pearls

Category: Toxicology

Title: Intralipid for Drug Overdose

Keywords: Intralipid, fat emulsion (PubMed Search)

Posted: 10/14/2010 by Bryan Hayes, PharmD (Updated: 12/9/2022)
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Emerging evidence supports using intravenous fat emulsion (Intralipid) therapy for various drug overdoses, particularly those that are lipophilic.  Within seconds to minutes of administration, toxic cardiovascular effects are reversed, including return of spontaneous circulation in cardiac arrest patients.  Central nervous system effects also tend to improve.

Lipophilic agents for which there has been success include:

  • Calcium channel blockers (verapamil, diltiazem, amlodipine)
  • Beta blockers
  • Bupropion
  • Quetiapine
  • Lamotrigine
  • Sertraline
  • TCA's
  • Diphenhydramine

Bottom line: Consider intralipid therapy early in the course of a hemodynamically unstable patient with suspected overdose.  Give a bolus of 1.5 mL/kg of 20% lipid emulsion over 1-2 minutes.