UMEM Educational Pearls

Category: Toxicology

Title: Treatment for Calcium Channel Blocker Poisoning: What's the Evidence?

Keywords: calcium channel blocker, poisoning (PubMed Search)

Posted: 10/6/2014 by Bryan Hayes, PharmD (Emailed: 10/9/2014) (Updated: 10/11/2014)
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In a precursor to a forthcoming international guideline on the management of calcium channel blocker poisoning, a new systematic review has been published assessing the available evidence.

A few findings from the systematic review:

  • The majority of literature on calcium channel blocker overdose management is heterogenous, biased, and low-quality evidence.
  • Interventions with the strongest evidence are high-dose insulin and extracorporeal life support.
  • Interventions with less evidence, but still possibly beneficial, include calcium, dopamine, norepinephrine, 4-aminopyridine (where available), and lipid emulsion therapy.

Stay tuned for the international guideline coming out soon. One treatment recommendation from the new guideline, reported at the 8th European Congress on Emergency Medicine last month, is not to use glucagon.


St-Onge M, et al. Treatment for calcium channel blocker poisoning: a systematic review. Clin Toxicol 2014. [Epub ahead of print]. [free full-text PDF]

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