No data are available on overdosage with Nebilet.
Symptoms: Symptoms of overdosage with β-blockers are bradycardia, hypotension, bronchospasm and acute cardiac insufficiency.
Treatment: In case of overdosage or hypersensitivity, the patient should be kept under close supervision and be treated in an intensive care ward. Blood glucose levels should be checked. Absorption of any drug residues still present in the GIT can be prevented by gastric lavage and the administration of activated charcoal and a laxative. Artificial respiration may be required. Bradycardia or extensive vagal reactions should be treated by administering atropine or methylatropine. Hypotension and shock should be treated with plasma/plasma substitutes and, if necessary, catecholamines.
The β-blocking effect can be counteracted by slow IV administration of isoprenaline HCl, starting with a dose of approximately 5 mcg/min, or dobutamine, starting with a dose of 2.5 mcg/min, until the required effect has been obtained. In refractory cases, isoprenaline can be combined with dopamine. If this does not produce the desired effect either, IV administration of glucagon 50-100 mcg/kg IV may be considered. If required, the injection should be repeated within 1 hr, to be followed (if required) by an IV infusion of glucagon 70 mcg/kg/hr. In extreme cases of treatment-resistant bradycardia, a pacemaker may be inserted.