Overdoses of<unk>  are extremely rare, but extremely toxic. Eight people are known to have overdosed since the drug's introduction in the mid-1950s, of which three have died. Chloroquine has a risk of death in overdose in adults of about 20%, while<unk>  is estimated to be two or threefold less toxic. Serious signs and symptoms of overdose generally occur within an hour of ingestion. These may include sleepiness, vision changes, seizures, coma, stopping of breathing, and heart problems such as ventricular fibrillation and low blood pressure. Loss of vision may be permanent. Low blood potassium, to levels of 1 to 2 mmol/L, may also occur. Cardiovascular abnormalities such as QRS complex widening and QT interval prolongation may also occur. Treatment recommendations include early mechanical ventilation, heart monitoring, and activated charcoal. Supportive treatment with intravenous fluids and vasopressors may be required with epinephrine being the vasopressor of choice. Stomach pumping may also be used. Sodium bicarbonate and hypertonic saline may be used in cases of severe QRS complex widening. Seizures may be treated with benzodiazepines. Intravenous potassium chloride may be required, however this may result in high blood potassium later in the course of the disease. Dialysis does not appear to be useful. Detection<unk>  may be quantified in plasma or serum to confirm a diagnosis of poisoning in hospitalized victims or in whole blood to assist in a forensic investigation of a case of sudden or unexpected death. Plasma or serum concentrations are usually in a range of 0.1-1.6 mg/L during therapy and 6–20 mg/L in cases of clinical intoxication, while blood levels of 20–100 mg/L have been observed in deaths due to acute overdosage.
Hydroxychloroquine
Azathioprine
Teriflunomide
Leflunomide
Tofacitinib
Etanercept
Cyclizine
Prednisolone