Intoxication with Calcium Channel Blockers and Other Highly Protein-Bound Drugs: Why Use MARS? Two Clinical Case Reports

Overdose with calcium channel blockers is often a life-threating condition that is frequently exacerbated by the availability of extended-release preparations with slow drug clearances. In the annual report of the American Association of Poison Control Centers, calcium channel inhibitor overdose is one of the most deadly poisonings. In addition, calcium channel blockers are highly bound to proteins, making them difficult to remove using standard dialysis techniques. We describe two cases of amlodipine overdose that presented with profound circulatory shock and were treated with the Molecular Adsorbent Recirculating System™ (MARS™). In this regard, the authors reviewed other cases reported in the literature to discuss the rationale for using albumin dialysis techniques in the setting of highly protein-bound drug intoxication.