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Calcium channel blocker toxicity

Guidelines

Key sources

The following summarized guidelines for the management of calcium channel blocker toxicity are prepared by our editorial team based on guidelines from the American Heart Association (AHA 2023), the American Heart Association (AHA/HRS/ACC 2019), and the Canadian Association of Poison Control Centres (CAPCC/ESICM/CAEP/AAPCC/SCCM/CPS/EAPCCT/ESEM/CCCS/ACMT 2017).
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Medical management

Gastric decontamination: as per AAPCC/ACMT/CAEP/…/SCCM 2017 guidelines, consider administering oral activated charcoal in patients who ingested a potentially toxic amount of CCB within 1 hour of presentation.
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  • Intravenous calcium

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  • Atropine

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  • Methylene blue

Therapeutic procedures

Temporary cardiac pacing: as per AHA 2023 guidelines, consider attempting electrical pacing for the management of refractory bradycardia in patients with CCB toxicity.
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