title: Two cases of fatal amlodipine overdose.
abstract: Two fatal overdoses of the calcium channel blocker amlodipine are described. Postmortem samples were screened for volatiles and therapeutic and abused drugs. Amlodipine was measured by liquid chromatography-atmospheric pressure photoionization-mass spectrometry. The heart blood amlodipine concentrations for the two cases were 2.4 and 0.95 mg/L, and amlodipine was quantified in all other tissues. In the first case, venlafaxine and norvenlafaxine were also found, and the angiotensin receptor antagonist olmesartan was tentatively identified. The concentrations of amlodipine are compared with previously reported fatal and nonfatal overdoses. The medical examiners ruled in both cases that the manner of death was suicide and the causes of death were mixed drug intoxication and amlodipine intoxication.
authors.affiliation: Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner, 1413 Research Blvd., Rockville, Maryland 20850, USA. Jason.Sklerov@dc.gov
authors.forename: Jason H
authors.initials: JH
authors.lastname: Sklerov
authors.forename: Barry
authors.initials: B
authors.lastname: Levine
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Ingwersen
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Aronica-Pollack
authors.forename: David
authors.initials: D
authors.lastname: Fowler
mesh_terms: D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000097:blood / Q000506:poisoning* / Q000652:urine; D000959:Antihypertensive Agents / Q000097:blood / Q000506:poisoning* / Q000652:urine; D002121:Calcium Channel Blockers / Q000097:blood / Q000506:poisoning* / Q000652:urine; D062787:Drug Overdose; D005260:Female; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D013405:Suicide; D014018:Tissue Distribution
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D017311:Amlodipine