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In the event of overdose, platelet counts may increase excessively and result in thrombotic/thromboembolic complications. In case of an overdose, consideration should be given to oral administration of a metal cation-containing preparation, such as calcium, aluminium, or magnesium preparations to chelate Revolade and thus limit absorption. Platelet counts should be closely monitored. Treatment with Revolade should be reinitiated in accordance with dosing and administration recommendations (see Dosage & Administration).
In the clinical studies there was one report of overdose where the patient ingested 5,000 mg of Revolade. Reported adverse reactions included mild rash, transient bradycardia, ALT and AST elevation, and fatigue. Liver enzymes measured between Days 2 and 18 after ingestion peaked at a 1.6-fold ULN in AST, a 3.9-fold ULN in ALT, and a 2.4-fold ULN in total bilirubin. The platelet counts were 672,000/μl on Day 18 after ingestion and the maximum platelet count was 929,000/μl. All events were resolved without sequelae following treatment.
Because Revolade is not significantly renally excreted and is highly bound to plasma proteins, haemodialysis would not be expected to be an effective method to enhance the elimination of Revolade.
