Overdose : מינון יתר

4.9 Overdose

Ibuprofen doses in excess of 400mg/kg may cause symptoms of toxicity whilst a risk of toxic effects should not be excluded with a dose above 100 mg/kg.

Symptoms of overdosing
The symptoms of overdose can include nausea, vomiting, abdominal pain or more rarely diarrhoea. Nystagmus, blurred vision, tinnitus, headache and gastrointestinal bleeding are also possible. In more serious poisoning toxicity is seen in the central nervous system, manifesting as vertigo, dizziness, drowsiness, occasionally excitation and disorientation, loss of consciousness or coma. Occasionally patients develop convulsions. In serious poisoning metabolic acidosis may occur, hypothermia and hyperkalaemia may also occur and the prothombin time/INR may be prolonged, probably due to the interference with the actions of circulating clotting factors. Acute renal failure, liver damage, hypotension, respiratory depression and cyanosis may occur. Exacerbation of asthma is possible in asthmatics.

Management
No special antidote is available.

Management should be symptomatic and supportive and include the management of a clear airway and monitoring of cardiac and vital signs until stable. Oral administration of activated charcoal or gastric emptying should be considered if the patient presents within one hour of ingestion of a potentially toxic amount. If ibuprofen has already been absorbed, alkaline substances may be administered to promote the excretion of acid Ibuprofen in the urine. If frequent or prolonged, convulsions should be treated with intravenous diazepam or lorazepam. For asthma bronchodilators should be given. The local poisons centre should be contacted for medical advice.