Antidotes and reversal agents
Each entry comes from the drug's FDA label, mostly its overdosage section. The first list covers drugs with a specific antidote or reversal agent.
The second list covers drugs whose label names none, with the supportive care the label describes instead.
Specific antidote or reversal (21)
AcetaminophenAnalgesics and antipyretics (non-opioid)
N-acetylcysteine (NAC), given as early as possible after a suspected overdose. Draw a serum acetaminophen level no sooner than 4 hours after an oral ingestion and plot it on the Rumack-Matthew nomogram; give the full NAC course if the level is above the lower treatment line. Check liver tests at the start and every 24 hours.
Sources: [1]
ApixabanDirect factor Xa inhibitors
Andexanet alfa reverses apixaban's anti-factor Xa effect in adults. Prothrombin complex concentrate or factor VIIa are options, though unstudied. Activated charcoal soon after ingestion lowers absorption. Hemodialysis does little, and protamine and vitamin K are not expected to work. The effect lasts at least 24 hours after the last dose.
AtropineAnticholinergics (antimuscarinics)
Physostigmine by slow IV injection (1 to 4 mg in adults, 0.5 to 1 mg in children) rapidly reverses delirium and coma from atropine overdose; it is short-acting, so doses may need repeating. Control marked excitement or seizures with a short-acting barbiturate or diazepam, support breathing, and cool the patient. Dialysis does not remove atropine.
Sources: [1]
Buprenorphine-naloxoneOpioid partial agonists
Naloxone, nalmefene, or another opioid overdose reversal agent can treat buprenorphine overdose, but higher than usual and repeated doses may be needed because buprenorphine binds the mu receptor tightly and acts for a long time. The first priority is restoring ventilation with an open airway and assisted breathing, plus oxygen, IV fluids, and vasopressors as needed. Monitor long enough to cover buprenorphine's long duration of action.
DigoxinCardiac glycosides
Digoxin immune Fab (DigiFab) for life-threatening arrhythmias, high-grade AV block, or hyperkalemia; it is 80% to 90% effective. Stop digoxin and place on a cardiac monitor. Correct low potassium (keep 4.0 to 5.5 mmol/L) and magnesium, but avoid potassium with bradycardia or heart block. Atropine or pacing for bradycardia. Give activated charcoal after a large ingestion. Dialysis does not remove digoxin.
Sources: [1]
DonepezilCholinesterase inhibitors
Atropine, a tertiary anticholinergic, is the antidote: IV atropine sulfate titrated to effect, starting with 1.0 to 2.0 mg IV. Overdose causes cholinergic crisis with slow heart rate, low blood pressure, severe nausea and vomiting, drooling, sweating, depressed breathing, collapse, and seizures; rising muscle weakness can be fatal if breathing muscles are involved. Give general supportive care. Quaternary anticholinergics such as glycopyrrolate have caused atypical blood pressure and heart rate responses with other cholinomimetics, and whether dialysis removes donepezil is unknown.
Sources: [1]
EnoxaparinHeparins
Protamine sulfate by slow IV injection only partly reverses it: 1 mg per 1 mg of enoxaparin given within the past 8 hours, or 0.5 mg per 1 mg if longer ago or if a second dose is needed. Anti-Xa activity is never fully neutralized (about 60% at most). After 12 hours protamine may not be needed. Protamine can cause severe hypotension and anaphylaxis-like reactions.
Sources: [1]
GlipizideSulfonylureas
Hypoglycemia: oral glucose for mild episodes without loss of consciousness. Coma or seizures: rapid IV 50% glucose, then a continuous 10% glucose infusion to keep glucose above 100 mg/dL. Monitor for at least 24 to 48 hours, because hypoglycemia can recur. Dialysis is unlikely to help because the drug is highly protein bound.
Sources: [1]
Heparin (unfractionated)Heparins
Protamine sulfate. About 1 mg neutralizes 100 units of heparin; give by slow infusion, no more than 50 mg in any 10 minutes. Less is needed as time passes because heparin is cleared quickly. Protamine can cause anaphylaxis-like reactions, so have resuscitation ready.
Sources: [1]
HydromorphoneOpioid agonists
Naloxone (or nalmefene) for clinically significant respiratory or circulatory depression, after securing the airway and ventilation. Reversal wears off before hydromorphone does, so keep monitoring until spontaneous breathing is reliable and redose as needed. In opioid-dependent patients, the usual dose can precipitate acute withdrawal.
Sources: [1]
Insulin glargineLong-acting insulins
Insulin lisproRapid-acting insulins
Hypoglycemia: oral glucose for mild episodes; a glucagon product or concentrated IV glucose for coma, seizures, or neurologic impairment. Continue carbohydrates and observation because lows can recur after apparent recovery. Correct hypokalemia.
Sources: [1]
Insulin NPH (isophane)Intermediate-acting insulins
Hypoglycemia: oral glucose for mild episodes; a glucagon product or concentrated IV glucose for coma, seizures, or neurologic impairment. Continue carbohydrates and observation because lows can recur after apparent recovery. Correct any hypokalemia.
Sources: [1]
Insulin regular (human)Short-acting insulins
Hypoglycemia: oral glucose for mild episodes; a glucagon product or IV glucose for coma, seizures, or neurologic impairment. Continue carbohydrates and observation because lows can recur. Correct any hypokalemia.
Sources: [1]
IsoniazidAntituberculosis drugs
Pyridoxine (vitamin B6) given IV. If the amount ingested is known, give pyridoxine gram for gram equal to the isoniazid dose as a slow IV bolus over 3 to 5 minutes; if unknown, start with 5 g in adults or 80 mg/kg in children, and repeat if seizures continue. Add diazepam for seizures that do not respond, support ventilation, and correct metabolic acidosis. Symptoms start 30 minutes to 3 hours after ingestion, and 80 to 150 mg/kg can be fatal if untreated.
Sources: [1]
LorazepamBenzodiazepines
Flumazenil, a benzodiazepine receptor antagonist, can reverse sedation but is an adjunct to airway support, IV fluids, and other supportive care. It can trigger withdrawal and seizures, especially with long-term benzodiazepine use or mixed overdose with tricyclic antidepressants, and is contraindicated when a benzodiazepine is controlling a life-threatening condition such as status epilepticus.
Sources: [1]
Magnesium sulfateMagnesium salts
An injectable calcium salt counteracts magnesium toxicity: IV calcium, 10 to 20 mL of a 5% solution. Keep it immediately available during treatment for eclampsia. Provide artificial ventilation until calcium takes effect; subcutaneous physostigmine 0.5 to 1 mg may help. Newborns with hypermagnesemia may need resuscitation, ventilation, and IV calcium.
MethotrexateAntimetabolites (folic acid antagonists)
Leucovorin or levoleucovorin, started as soon as possible after an overdose, lessens methotrexate toxicity; serum creatinine and methotrexate levels guide their dosing. Glucarpidase treats toxic plasma levels (above 1 micromole per liter) with delayed clearance from impaired kidney function. Give hydration and urinary alkalinization. Standard hemodialysis and peritoneal dialysis have not been shown to help, though high-flux hemodialysis has cleared it.
MorphineOpioid agonists
Naloxone (or nalmefene) for significant respiratory or circulatory depression, after securing the airway and breathing. Reversal wears off before morphine does, so keep monitoring and redose as needed. In opioid-dependent patients, titrate small doses to avoid precipitating severe withdrawal.
Sources: [1]
NaloxoneOpioid antagonists
Naloxone is itself the opioid antidote. Overdose of naloxone is treated with symptom-based care under close supervision; volunteers given 24 mg/70 kg showed no toxicity.
Sources: [1]
WarfarinVitamin K antagonists
Vitamin K1 (phytonadione), oral or IV, after stopping warfarin. For urgent reversal in life-threatening bleeding: prothrombin complex concentrate, fresh frozen plasma, or activated factor VII, which carry thrombosis and infection risks.
Sources: [1]
No specific antidote (68)
AcyclovirHerpes antivirals (nucleoside analogues)
No specific antidote. Overdoses up to 20 g have caused agitation, lethargy, seizures, and coma, and drug crystals in the renal tubules can cause acute renal failure. Give supportive care with attention to fluids; hemodialysis lowers plasma levels about 60% over a 6-hour session and may help in acute renal failure with anuria.
AdenosineAntiarrhythmics
No specific antidote. The half-life is under 10 seconds, so adverse effects usually resolve on their own; treat any prolonged effect directly. Methylxanthines such as caffeine and theophylline are competitive antagonists. Keep resuscitation equipment available, and give no further doses to a patient who develops high-level block.
AfamelanotideMelanocortin receptor agonists
AlbuterolShort-acting beta-2 agonists
No specific antidote. Overdose causes excess beta stimulation: tachycardia up to 200 beats/min, arrhythmias, seizures, hypokalemia, and hyperglycemia. Stop the drug and treat symptoms. A cardioselective beta blocker may be considered cautiously because it can trigger bronchospasm.
Sources: [1]
AlendronateBisphosphonates
No specific antidote. Give milk or antacids to bind the drug, do not induce vomiting, and keep the patient fully upright. Watch for hypocalcemia, hypophosphatemia, and upper GI injury. Dialysis does not help.
Sources: [1]
AllopurinolAntigout agents (xanthine oxidase inhibitors)
No specific antidote. Allopurinol and oxypurinol are dialyzable, but whether hemodialysis or peritoneal dialysis helps after an overdose is unknown.
Sources: [1]
AlteplaseThrombolytics (fibrinolytics)
AmiodaroneAntiarrhythmics
AmitriptylineTricyclic antidepressants (TCAs)
No specific antidote; overdose can be fatal and needs hospital care, ideally with poison control input. Get an ECG and start cardiac monitoring at once; a limb-lead QRS of 0.10 seconds or more may be the best sign of a severe overdose. Give IV sodium bicarbonate to keep serum pH at 7.45 to 7.55 for conduction problems and dysrhythmias, treat seizures with benzodiazepines, and avoid class 1A and 1C antiarrhythmics; inducing vomiting is contraindicated, and physostigmine is only for life-threatening symptoms unresponsive to other therapy. Observe with cardiac monitoring for at least 6 hours.
Sources: [1]
AmlodipineCalcium channel blockers
No specific antidote. Overdose causes marked vasodilation, hypotension, and possibly reflex tachycardia. Treat with cardiac monitoring, leg elevation, fluids, and vasopressors such as phenylephrine if needed. Hemodialysis is unlikely to help because the drug is highly protein bound.
Sources: [1]
AmoxicillinPenicillins
No antidote. Stop the drug and give supportive care, keeping fluid intake and urine output up to prevent crystalluria. Hemodialysis removes amoxicillin.
Sources: [1]
AspirinNonsteroidal anti-inflammatory drugs (NSAIDs)
AtorvastatinStatins (HMG-CoA reductase inhibitors)
No specific antidote. Hemodialysis is not expected to help because the drug is highly protein bound.
Sources: [1]
AzithromycinMacrolides
No antidote. Overdose causes mainly nausea, diarrhea, and vomiting; give symptom-based supportive care.
Sources: [1]
Calcium gluconateCalcium salts
No specific antidote. For overdose with hypercalcemia (symptoms usually appear at total calcium of 12 mg/dL or more), stop the infusion, restore intravascular volume, and promote urinary calcium excretion if needed. For extravasation or calcinosis cutis, stop IV administration at that site right away and treat as needed.
CarbamazepineAntiepileptics (anticonvulsants)
No specific antidote. Signs begin 1 to 3 hours after ingestion and are mainly neuromuscular: impaired consciousness up to coma, convulsions (especially in small children), twitching, tremor, ataxia, nystagmus, and dilated pupils, with irregular or depressed breathing, tachycardia, blood pressure changes, and conduction disorders. Remove the drug early (gastric lavage, activated charcoal), protect the airway, treat shock with fluids and vasopressors if needed, and treat seizures with diazepam or barbiturates while watching for worse respiratory depression. Monitor breathing, ECG, blood pressure, temperature, and kidney and bladder function for several days; dialysis is for severe poisoning with renal failure.
Sources: [1]
Carbidopa-levodopaAntiparkinson agents (dopaminergic)
No specific antidote; pyridoxine does not reverse it. Give supportive care with judicious IV fluids, maintain the airway, and monitor the ECG for arrhythmias, treating them as needed. The value of dialysis is unknown.
Sources: [1]
CeftriaxoneCephalosporins
No specific antidote. Stop the drug and give symptom-based supportive care. Hemodialysis and peritoneal dialysis do not lower levels. Overdose in severe renal impairment has caused encephalopathy and seizures.
Sources: [1]
CiprofloxacinFluoroquinolones
No antidote. Give supportive care with good hydration, and monitor kidney function and urine pH, acidifying if needed to prevent crystalluria. Magnesium, aluminum, or calcium antacids reduce further absorption. Dialysis removes less than 10%.
Sources: [1]
ClonidineCentral alpha-2 agonists
No specific antidote. Overdose can cause early hypertension, then hypotension, bradycardia, respiratory depression, hypothermia, drowsiness, reduced reflexes, and small pupils, usually within 30 minutes to 2 hours; as little as 0.1 mg has caused toxicity in children. Do not induce vomiting; consider gastric lavage or activated charcoal, and give atropine for bradycardia, IV fluids or vasopressors for hypotension, and vasodilators for hypertension. Naloxone may help respiratory depression, hypotension, or coma, but watch for paradoxical hypertension. Dialysis is unlikely to help much.
Sources: [1]
ClopidogrelP2Y12 inhibitors (antiplatelets)
ClozapineAtypical antipsychotics
No specific antidote. Common overdose findings are sedation, delirium, coma, tachycardia, hypotension, hypersalivation, and respiratory depression or failure, with aspiration pneumonia, arrhythmias, and seizures reported; fatal overdoses generally involved more than 2500 mg. Establish an airway with adequate oxygenation and ventilation, monitor cardiac status and vital signs, give supportive care, consider other drugs taken, and contact a poison control center.
DiltiazemCalcium channel blockers
No specific antidote; give supportive care. Bradycardia or high-degree AV block: atropine (0.6 to 1 mg), then cautious isoproterenol if there is no response; fixed high-degree block needs pacing. Heart failure: inotropes (isoproterenol, dopamine, or dobutamine) and diuretics. Hypotension: vasopressors such as dopamine or norepinephrine. IV calcium (calcium chloride 1 g or calcium gluconate 3 g, each given over 5 minutes, with repeat doses every 10 to 20 minutes as needed) has given inconsistent results but improved the response to atropine in some cases; watch for hypercalcemia. Dialysis does not remove diltiazem.
DoxycyclineTetracyclines
No specific antidote. For overdose, stop the drug and give symptomatic and supportive care; dialysis does not help.
Sources: [1]
ElamipretideMitochondria-targeted peptides
No specific antidote. No overdoses occurred in trials; symptoms would likely be histamine-related, such as low blood pressure or near-fainting. Interrupt treatment and give standard supportive care.
Sources: [1]
EmpagliflozinSGLT2 inhibitors
No specific antidote. For overdose, contact Poison Help or a medical toxicologist. Removal by hemodialysis has not been studied.
Sources: [1]
EpinephrineAdrenergic agonists (sympathomimetics)
No specific antidote; it is rapidly inactivated, so care is supportive. Severe hypertension or pulmonary edema: a fast-acting vasodilator or alpha blocker such as phentolamine, plus respiratory support. Arrhythmias: a beta blocker such as propranolol. Extravasation ischemia: infiltrate the area with phentolamine diluted in saline.
FluconazoleAntifungals (azoles)
No specific antidote. Overdose has caused hallucinations and paranoid behavior; give symptomatic and supportive care, with gastric lavage if indicated. A 3-hour hemodialysis session lowers plasma levels by about 50%.
Sources: [1]
FluticasoneInhaled corticosteroids
FurosemideLoop diuretics
No antidote. Overdose causes dehydration, low blood volume, hypotension, and electrolyte loss. Replace fluid and electrolytes and check electrolytes, CO2, and blood pressure often. Hemodialysis does not speed elimination.
Sources: [1]
GabapentinGabapentinoids
No specific antidote. Overdose causes double vision, slurred speech, drowsiness, lethargy, and diarrhea; fatal respiratory depression has occurred, especially with other CNS depressants. Give supportive care. Hemodialysis removes gabapentin.
Sources: [1]
GentamicinAminoglycosides
GlucagonAntihypoglycemics
No specific antidote. Overdose can cause nausea, vomiting, slowed GI motility, and a rise in blood pressure and pulse; serum potassium may fall, so check and correct it. For a dramatic blood pressure rise, IV phentolamine has lowered pressure effectively for the short period control is needed.
HaloperidolTypical antipsychotics (first-generation)
No specific antidote; care is supportive. Secure the airway and ventilate, treat hypotension with IV fluids and phenylephrine or norepinephrine (never epinephrine), give antiparkinson medicine for severe extrapyramidal reactions, and monitor the ECG for QT prolongation until normal. Dialysis removes very little.
HydralazineDirect vasodilators
No specific antidote. Overdose causes hypotension, tachycardia, headache, and flushing and can lead to myocardial ischemia, arrhythmias, and profound shock. Supporting the circulation comes first: treat shock with plasma expanders, avoid vasopressors if possible, and treat tachycardia with a beta blocker. After an oral overdose, empty the stomach with airway protection and consider activated charcoal once the circulation is stable.
HydrochlorothiazideThiazide diuretics
No antidote. Overdose mainly causes dehydration and loss of potassium, chloride, and sodium; with digitalis, hypokalemia can worsen arrhythmias. Give supportive care and correct fluids, electrolytes, and blood pressure. It is not known how well hemodialysis removes it.
Sources: [1]
IbuprofenNonsteroidal anti-inflammatory drugs (NSAIDs)
No specific antidote. Overdose care is supportive; because the drug is acidic and excreted in urine, alkaline diuresis may help in theory.
Sources: [1]
LabetalolBeta blockers
No specific antidote. Overdose causes posture-sensitive hypotension and sometimes marked bradycardia: lay the patient flat, raise the legs if needed, and give supportive care. Shortly after an oral overdose, gastric lavage may help remove the drug. Hemodialysis and peritoneal dialysis remove less than 1%.
Levonorgestrel-ethinyl estradiolHormonal contraceptives
No antidote. Overdose may cause nausea and uterine bleeding; give supportive care.
Sources: [1]
LevothyroxineThyroid hormones
No antidote. Overdose looks like hyperthyroidism, sometimes with confusion, and can be delayed for days. Reduce or pause the dose and give supportive care.
Sources: [1]
LisinoprilACE inhibitors
No specific antidote. Overdose mainly causes hypotension, treated with IV normal saline. Lisinopril can be removed by hemodialysis.
Sources: [1]
LithiumMood stabilizers
No specific antidote. Mild toxicity: lower or stop the dose. Severe toxicity: hemodialysis is the treatment of choice; activated charcoal does not bind lithium. Protect the airway, correct volume and electrolyte problems, and recheck levels because they can rebound as lithium leaves the tissues. Levels above 3 mEq/L can lead to seizures, coma, and brain damage.
Sources: [1]
LosartanAngiotensin II receptor blockers (ARBs)
No antidote. Overdose most likely causes hypotension and tachycardia, or bradycardia from vagal stimulation. Give supportive care for symptomatic hypotension. Hemodialysis does not remove losartan or its active metabolite.
Sources: [1]
MetforminBiguanides
MethimazoleAntithyroid drugs (thionamides)
No antidote. Overdose may cause nausea, vomiting, epigastric distress, headache, fever, joint pain, itching, and edema, and aplastic anemia or agranulocytosis can appear within hours to days. Hepatitis, nephrotic syndrome, exfoliative dermatitis, neuropathy, and CNS stimulation or depression are less frequent. Give supportive care, consider other drugs taken, and contact a poison control center.
Sources: [1]
MethylphenidateCNS stimulants
No specific antidote. Overdose causes sympathomimetic toxicity: fast arrhythmias, high or low blood pressure, agitation, confusion, hallucinations, seizures, and life-threatening hyperthermia (above 104°F) with rhabdomyolysis. Give supportive care, consider multiple drug ingestion, and contact Poison Help or a toxicologist; dialysis does not help because of the large volume of distribution and rapid metabolism.
Sources: [1]
MetoprololBeta blockers
No single antidote. Treat bradycardia with atropine, adrenergic drugs, or pacing; hypotension with vasopressors such as norepinephrine; heart failure or shock with fluids, glucagon, and dobutamine; and bronchospasm with bronchodilators. Hemodialysis does not help.
Sources: [1]
MetronidazoleAntiprotozoals and anaerobic antibiotics (nitroimidazoles)
No specific antidote; treat overdose symptomatically and supportively. Single oral doses up to 15 g caused nausea, vomiting, and ataxia.
Sources: [1]
MontelukastLeukotriene receptor antagonists
No specific antidote. Use usual supportive measures, such as removing unabsorbed drug, clinical monitoring, and supportive therapy. Whether dialysis removes montelukast is unknown.
Sources: [1]
NitrofurantoinUrinary tract antibacterials
No specific antidote. Acute overdose has caused only vomiting; induce emesis and keep fluid intake high to promote urinary excretion. Nitrofurantoin is dialyzable.
Sources: [1]
NitroglycerinNitrates
No specific antagonist. Treat hypotension by raising central volume: lay the patient flat in a shock position with legs elevated and give IV normal saline. Epinephrine does not reverse it and is not recommended. For methemoglobinemia, give IV methylene blue 1 to 2 mg/kg unless the patient has G-6-PD deficiency.
Sources: [1]
NorepinephrineAdrenergic agonists (sympathomimetics)
No reversal agent. Overdose causes headache, severe hypertension, reflex bradycardia, a sharp rise in peripheral resistance, and lower cardiac output; stop the infusion until the patient stabilizes. For extravasation, infiltrate the ischemic area as soon as possible with 5 to 10 mg of phentolamine in 10 to 15 mL of 0.9% sodium chloride through a fine needle; infiltration within 12 hours produces prompt local hyperemia.
OmeprazoleProton pump inhibitors
No specific antidote. Treat overdose with symptomatic and supportive care. Omeprazole is highly protein bound, so dialysis does not remove it well.
Sources: [1]
Ondansetron5-HT3 receptor antagonists
No specific antidote; give supportive care. Very large IV doses have been given by mistake without major harm. Overdose has caused hypotension, brief blindness, and heart block, and serotonin syndrome in young children who swallowed tablets.
Sources: [1]
OxytocinOxytocics (uterine stimulants)
PhenytoinAntiepileptics (anticonvulsants)
No antidote. Early overdose signs are nystagmus, ataxia, and slurred speech, progressing to lethargy, coma, hypotension, bradycardia, and cardiac arrest. Support breathing and circulation; hemodialysis can be considered. Consider other CNS depressants such as alcohol.
Sources: [1]
Phytonadione (vitamin K)Vitamin K replacements
None. Treat hypersensitivity reactions as an emergency, and stop the drug for skin reactions and manage medically. Newborn overdose can cause hemolysis, jaundice, and hyperbilirubinemia. If reversal goes too far while anticoagulation is still needed, heparin still works because phytonadione does not affect it.
Potassium chloridePotassium supplements
No specific antidote; treat hyperkalemia. Stop all potassium sources, including potassium-sparing drugs. Give IV calcium gluconate if digitalis toxicity risk is low, IV dextrose with insulin, and sodium bicarbonate for acidosis; remove potassium with exchange resins or dialysis. Monitor the ECG closely. ER tablets can delay absorption and toxicity for hours.
PrednisoneCorticosteroids
QuetiapineAtypical antipsychotics
No specific antidote. Overdose causes drowsiness, sedation, tachycardia, hypotension, and anticholinergic toxicity, with QT prolongation reported. Secure the airway and breathing, start continuous ECG monitoring at once, and give supportive care.
Sources: [1]
SemaglutideGLP-1 receptor agonists
No specific antidote. Give supportive care based on symptoms, such as nausea, vomiting, and hypoglycemia. Observation may need to be prolonged because the half-life is about 1 week.
Sources: [1]
SertralineSelective serotonin reuptake inhibitors (SSRIs)
No specific antidote. Overdose can cause delayed seizures, altered mental status, QRS or QTc prolongation, and serotonin syndrome. Consider activated charcoal if the patient presents early, and provide supportive care.
Sources: [1]
SpironolactoneAldosterone antagonists (potassium-sparing diuretics)
No specific antidote. Overdose may cause drowsiness, confusion, rash, nausea, vomiting, dizziness, or diarrhea; hyperkalemia is most likely with renal impairment. Give supportive care for fluids, electrolytes, and vital functions, and stop the drug if hyperkalemia develops.
Sources: [1]
TesamorelinGrowth hormone secretagogues (GHRH analogs and ghrelin receptor agonists)
No specific antidote, and the label has no overdosage section. Stop the drug and give supportive care.
Sources: [1]
TirzepatideDual and triple incretin agonists (GIP/GLP-1 and GIP/GLP-1/glucagon)
No specific antidote. Give supportive care based on symptoms and consider contacting Poison Help. Observation may need to be prolonged because the half-life is about 5 days.
Sources: [1]
Trimethoprim-sulfamethoxazoleSulfonamide antibiotics (sulfa drugs)
No specific antidote. With normal kidneys and low urine output, give IV fluids; acidifying the urine speeds trimethoprim elimination. Hemodialysis is only moderately effective. For bone marrow depression from high-dose or prolonged use, give leucovorin 5 to 15 mg daily until blood counts recover.
Sources: [1]
Valproic acidAntiepileptics (anticonvulsants)
No specific antidote. Give supportive care and maintain urine output; hemodialysis, or hemodialysis with hemoperfusion, can remove significant drug in overdose. Naloxone has reversed CNS depression but may also reverse its antiseizure effect, so use it cautiously in epilepsy.
Sources: [1]
VancomycinGlycopeptide antibiotics
No antidote. Give supportive care and protect kidney function. Standard dialysis removes little vancomycin; hemofiltration and hemoperfusion with polysulfone resin have increased clearance.
Sources: [1]