Emergency Medicine

UMEM Educational Pearls

Search

Title: Is there a significant adverse effect associated with double dose ingestion of a single medication?

Category: Toxicology

Keywords: double-dose of single medication (PubMed Search)

Posted: 12/27/2018 by Hong Kim, MD (Updated: 3/3/2026)

Taking a double-dose of a single medication is presumed to be safe in most cases. However, there is limited data to support this assumption.

 

A retrospective study of the California Poison Control System was performed to assess adverse effects of taking double dose of a single medication. During a 10-year period, 876 cases of double-dose ingestion of single medication were identified.

 

Adverse effects were rare (12 cases). However, medication classes that were involved in severe adverse effects included: 

  1. Propafenone: ventricular tachycardia and syncope
  2. Beta blockers (BB): bradycardia and hypotension
  3. Calcium channel blockers (CCB): bradycardia and hypotension
  4. Bupropion: seizure 
  5. Tramadol: ventricular tachycardia

Conclusion:

  • Adverse effect from double dosing is rare.
  • Cardiovascular collapse can occur with BB and CCB
  • Seizure can occur with tramadol and bupropion.

References

Correia MS et al. A 10-year review of single medication double-dose ingestions in the nation's largest poison control system. Clin Toxicol 2018 Nov 28:1-5. doi: 10.1080/15563650.2018.1493205. [Epub ahead of print]