Amlodipine Toxicity: A Case Report Salvaged with Extracorporeal Membrane Oxygenation and Overview of the Current Literature

Amlodipine is a widely prescribed calcium channel blocker (CCB). It is effective in managing hypertension and angina; however, it poses significant risks in overdose, leading to severe cardiovascular and systemic toxicity. This report describes a complicated hospital course of a 21-year-old female who presented to the Emergency Department (ED) after ingesting 150 mg of amlodipine in a suicide attempt with refractory distributive shock and acute respiratory distress syndrome (ARDS). Despite aggressive medical management, including high-dose insulin euglycemic therapy and vasopressors, the patient remained hypotensive and required veno-arterial extracorporeal membrane oxygenation (ECMO). ECMO was initiated after consultation with toxicology and cardiothoracic surgery teams, leading to successful decannulation after 3 days. However, the patient developed ARDS necessitating reintubation and antibiotic therapy. After 17 days of hospitalization, the patient absconded neurologically intact and without sequelae. This case highlights the challenges of managing amlodipine toxicity, as there is currently little insufficient data guiding the approach to managing complicated CCB overdose.