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There is limited clinical experience with VIMPAT overdose in humans. The highest reported accidental overdose of VIMPAT during clinical development was 1200 mg/day. The types of adverse events experienced by patients exposed to supratherapeutic VIMPAT doses during clinical trials were not clinically different from those of patients administered recommended doses of VIMPAT. None were fatal.
There has been a single case of intentional overdose in a clinical trial by a patient who self-administered 12,000 mg VIMPAT along with large doses of zonisamide, topiramate, and gabapentin. The patient presented in a coma with AV block, generalized tonic-clonic seizures and was hospitalized. An EEG revealed epileptic waveforms. The patient recovered 2 days later.
In postmarketing experience, fatal cardiac arrest was reported following an acute overdose of 7,000 mg of VIMPAT in a patient with cardiovascular risk factors; however, the case may have been confounded by the potential, but unproven, overdose of nicardipine. In postmarketing reports following single acute overdoses of 1,000 mg or greater of VIMPAT, cardiac conduction disorders, confusion, decreased level of consciousness, and seizures (generalized tonic-clonic seizures and status epilepticus) have been observed.
There is no specific antidote for overdose with VIMPAT. Standard decontamination procedures should be followed. General supportive care of the patient is indicated including monitoring of vital signs and observation of the clinical status of patient. A Certified Poison Control Center should be contacted for up to date information on the management of overdose with VIMPAT.
Standard hemodialysis procedures result in significant clearance of VIMPAT (reduction of systemic exposure by 50% in 4 hours). Hemodialysis has not been performed in the few known cases of overdose, but may be indicated based on the patient's clinical state or in patients with significant renal impairment.
None.This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 4/10/2017
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