Use of Phenylephrine in Amlodipine Overdose With Refractory Hypotension and Noncardiogenic Pulmonary Edema: A Case Report

Amlodipine is a commonly prescribed antihypertensive drug. We present a case of a young woman with a 70 mg amlodipine overdose admitted to our hospital with refractory hypotension and noncardiogenic pulmonary edema. She was initially managed in the intensive care unit (ICU) with intravenous sodium chloride 0.9% fluid boluses, calcium gluconate, and norepinephrine infusion, with poor response to therapy. After receiving phenylephrine 0.1 mg intravenous bolus, the patient showed improvement in blood pressure but experienced clinical worsening of pulmonary edema, which was subsequently managed with oxygen and furosemide therapy. With gradual clinical improvement, the patient was successfully discharged home on the fifth day. This case highlights that phenylephrine may be the drug of choice to treat refractory hypotension in amlodipine overdose without pulmonary edema.