Zaleplon overdose
1
Reactions 933 - 11 Jan 2003 ★ O Zaleplon overdose First report of coma and urine discolouration: 2 case reports Two patients became comatose with bluish-green urine discolouration after ingesting unknown amounts of zaleplon. A 55-year-old man was found unconscious with a bottle of whisky beside him. His pupils were pinpoint but reactive to light, his BP was 95/50mm Hg and his HR was 62 beats/min. He received IV flumazenil 0.4mg without success. A urine catheter was inserted and his urine showed a strong bluish- green discolouration. He subsequently received IV naloxone without effect. It was revealed that he had access to zaleplon and IV flumazenil 1mg over 4 minutes was given; he immediately awoke. He confirmed intake of whisky and a large amount of zaleplon but, within 1 hour, again became comatose. He received flumazenil and woke suddenly. He recovered completely over the next 7 hours and was discharged that evening. A 68-year-old woman was found unconscious in bed with several empty packages of zaleplon and trimipramine beside her. She was admitted to hospital deeply unconscious with almost no motor response to pain and a BP of 80/60mm Hg. An ECG showed sinus bradycardia with AV block I and a slightly wide QRS complex. She received IV flumazenil 0.5mg without success. Gastric lavage revealed a bluish gastric fluid and, 1 hour later, her urine was strongly bluish-green. She was transferred to an intensive care unit where her subsequent clinical course was uneventful. Two days later, she was fully awake and her ECG had normalised. [Patient outcome not stated.] Author comment: "The urine discolouration after zaleplon overdose is very likely due to the relatively high content of indigo carmine, 7mg, in zaleplon capsules. . . The finding of bluish-green urine in a comatose patient may indicate zaleplon overdose.’ H¨ ojer J, et al. Zaleplon-induced coma and bluish-green urine: possible antidotal effect by flumazenil. Journal of Toxicology - Clinical Toxicology 40: 571-572, No. 5, 2002 - Sweden 807211042 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of coma or urine discolouration associated with zaleplon. The WHO Adverse Drug Reactions database contained two reports of coma associated with zaleplon. 1 Reactions 11 Jan 2003 No. 933 0114-9954/10/0933-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Zaleplon overdose
Reactions 933 - 11 Jan 2003
★ OZaleplon overdose
First report of coma and urine discolouration:2 case reports
Two patients became comatose with bluish-green urinediscolouration after ingesting unknown amounts of zaleplon.
A 55-year-old man was found unconscious with a bottle ofwhisky beside him. His pupils were pinpoint but reactive tolight, his BP was 95/50mm Hg and his HR was 62 beats/min.He received IV flumazenil 0.4mg without success. A urinecatheter was inserted and his urine showed a strong bluish-green discolouration. He subsequently received IV naloxonewithout effect. It was revealed that he had access to zaleplonand IV flumazenil 1mg over 4 minutes was given; heimmediately awoke. He confirmed intake of whisky and a largeamount of zaleplon but, within 1 hour, again becamecomatose. He received flumazenil and woke suddenly. Herecovered completely over the next 7 hours and wasdischarged that evening.
A 68-year-old woman was found unconscious in bed withseveral empty packages of zaleplon and trimipramine besideher. She was admitted to hospital deeply unconscious withalmost no motor response to pain and a BP of 80/60mm Hg.An ECG showed sinus bradycardia with AV block I and aslightly wide QRS complex. She received IV flumazenil 0.5mgwithout success. Gastric lavage revealed a bluish gastric fluidand, 1 hour later, her urine was strongly bluish-green. She wastransferred to an intensive care unit where her subsequentclinical course was uneventful. Two days later, she was fullyawake and her ECG had normalised. [Patient outcome notstated.]
Author comment: "The urine discolouration after zaleplonoverdose is very likely due to the relatively high content ofindigo carmine, 7mg, in zaleplon capsules. . . The finding ofbluish-green urine in a comatose patient may indicate zaleplonoverdose.’Hojer J, et al. Zaleplon-induced coma and bluish-green urine: possible antidotaleffect by flumazenil. Journal of Toxicology - Clinical Toxicology 40: 571-572, No.5, 2002 - Sweden 807211042
» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of coma or urinediscolouration associated with zaleplon. The WHO AdverseDrug Reactions database contained two reports of comaassociated with zaleplon.
1
Reactions 11 Jan 2003 No. 9330114-9954/10/0933-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
