Calcium gluconate in severe verapamil intoxication

To the Editor: Intoxication with verapamil is a serious and often fatal condition, complicated by severe hypotension and cardiac-conduction abnormalities¹–⁴. The current therapeutic approach involves intravenous atropine, catecholamines, ventilation, and the insertion of a pacemaker. A 65-year-old woman treated with sustained-release verapamil for hypertension was admitted to our hospital in a coma (Glasgow coma score, 4). The blood pressure was 83/63 mm Hg, and the heart rate was 42 beats per minute (atrioventricular nodal rhythm with right bundle-branch block). The results of a routine drug screening were negative. Verapamil overdose was suspected, and gastric lavage was performed. The.