Topdip Overdose

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What happens if I overdose Topdip?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Topdip:

Store Topdip at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Topdip out of the reach of children and away from pets.

Overdose of Topdip in details

When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.
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Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of Topdip besylate is limited.

Single oral doses of Topdip maleate equivalent to 40 mg Topdip/kg and 100 mg Topdip/kg in mice and rats, respectively, caused deaths. Single oral Topdip maleate doses equivalent to 4 or more mg Topdip/kg or higher in dogs (11 or more times the maximum recommended human dose on a mg/m2 basis) caused a marked peripheral vasodilation and hypotension.

If massive overdose should occur, initiate active cardiac and respiratory monitoring. Frequent blood pressure measurements are essential. Should hypotension occur, provide cardiovascular support including elevation of the extremities and the judicious administration of fluids. If hypotension remains unresponsive to these conservative measures, consider administration of vasopressors (such as phenylephrine) with attention to circulating volume and urine output. As Topdip besylate is highly protein bound, hemodialysis is not likely to be of benefit.

What should I avoid while taking Topdip?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of Topdip.

Topdip warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
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Hypotension

Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. Because of the gradual onset of action, acute hypotension is unlikely.

Increased Angina or Myocardial Infarction

Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of Topdip besylate tablets, particularly in patients with severe obstructive coronary artery disease.

Patients with Hepatic Failure

Because Topdip besyaate is extensively metabolized by the liver and the plasma elimination half-life (t1/2) is 56 hours in patients with impaired hepatic function, titrate slowly when administering Topdip besylate to patients with severe hepatic impairment.

What should I discuss with my healthcare provider before taking Topdip?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Topdip, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to Topdip or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Topdip to treat high blood pressure in children younger than 6 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Topdip in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving Topdip.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking Topdip, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using Topdip with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using Topdip with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of Topdip. Make sure you tell your doctor if you have any other medical problems, especially:

Topdip precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.
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Use with caution in patients with severe bradycardia, heart failure (particularly in combination with a β-blocker), cardiogenic shock because of the risk of a slight negative inotropic effect and potent hypotensive effects.

Monitor signs and symptoms of worsening heart failure in patients with left ventricular dysfunction who are receiving Topdip for the treatment of angina.

Although hemodynamic studies and a controlled trial in NYHA class II-III heart failure patients have shown that Topdip did not lead to clinical deterioration as measured by exercise tolerance, left ventricular ejection fraction, and clinical symptomatology, studies have not been performed in patients with NYHA class IV heart failure. In general, all calcium channel blockers should be used with caution in patients with heart failure.

Topdip decreases peripheral resistance and can worsen hypotension; hence, it should not be used in patients with systolic blood pressure <90 mm Hg. Dizziness induced by hypotensive effect may occur.

Topdip is not a β-blocker and therefore gives no protection against the dangers of abrupt β-blocker withdrawal; any such withdrawal should be by gradual reduction of the dose of β-blocker.

Use with caution in patients with hepatic disease. The Topdip plasma elimination t½ is prolonged (56 hrs) in patients with hepatic disease and dosage adjustment is recommended.

Effects on the Ability to Drive or Operate Machinery: Patients should observe caution while driving, operating machinery or performing other tasks requiring alertness.

Use in pregnancy: Pregnancy Category C: Topdip has been shown to be fetotoxic in laboratory animals. No adequate or well-controlled studies have been done in humans. Topdip should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.

Use in lactation: It is not known whether Topdip is excreted into human milk, so clinicians should consider risk/benefit ratio for breastfeeding women.

Use in children: The effect of Topdip on blood pressure in patients <6 years is not known.

Use in the

Elderly: Elderly patients are more likely to experience a delayed clearance of Topdip and can be at greater risk for toxicity. Observe caution in Topdip dose selection for an elderly. Start at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant disease or other drug therapy. Elderly patients have decreased Topdip clearance with a resulting increase in AUC of approximately 40-60%, and a lower initial dose may be required.

What happens if I miss a dose of Topdip?

When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.



References

  1. DrugBank. "amlodipine". http://www.drugbank.ca/drugs/DB00381 (accessed September 17, 2018).
  2. MeSH. "Antihypertensive Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  3. Safe Work Australia - HCIS. "88150-42-9: The Hazardous Chemical Information System (HCIS) at the Safe Work Australia is a database of chemical classifications and workplace exposure standards. It allows users to find information on chemicals that have been classified in accordance with the GHS or which have an Australian Workplace Exposure Standard.". http://hcis.safeworkaustralia.gov.au... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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