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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17517
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I accidentally took a double dose of montelukast sod 10mg

Customer Question

Hi. I accidentally took a double dose of montelukast sod 10mg and diltiazem24 hr er 180 mg. my blood pressure is up. Should I be worried?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
How long ago did you take the extra dose of these medicines?
Are you having any symptoms?
How high is the blood pressure?
Do you also have your heart rate?
Customer: replied 1 year ago.
Took 1st dose 3 1/2 hours ago. Took 2nd dose 2 hours ago. Just took blood pressure again. It's now 158 over 90. Pulse at 73. I feel a little nauseous and tired. I'm sure I'm anxious also. Thanks
Expert:  Dr. D. Love replied 1 year ago.
Thank you for the additional information.
This is not a concern and there is no evidence of any problem related to taking the extra dose of these two medicines at this point in time.
There is no concern at all about the extra dose of montelukast. In the original studies of this drug, it was used in doses up to 200 mg per day for months without any significant difference in side effects. The higher doses were not found to be more effective, so the higher doses are not used, but they certainly can be safely tolerated.
The only issue in this situation is the extra dose of the diltiazem. The extra dose of diltiazem is still within the dosing range that is used for the diltiazem, but higher doses of the diltiazem can have a greater impact on blood pressure and heart rate, and lowering the blood pressure or heart rate can cause symptoms of lightheadedness or dizziness. In your case, there is no evidence of low blood pressure or heart rate and apparently are not having worrisome symptoms. If anything, the fact that your blood pressure is on the high side would indicate that there is a safety buffer to avoid a blood pressure that is too low.
Since it has been two hours since the extra dose, a significant amount of the drug has been absorbed, so the fact that the current blood pressure and pulse are not too low is a good sign. However, the drug levels will continue to increase over the next few hours. It would be appropriate to continue to monitor the blood pressure and pulse over the next 6-12 hours, but since the blood pressure and pulse are good at this time, the odds are great that they will continue to do well and not get too low.
If I can provide any further information, please let me know.
Customer: replied 1 year ago.
My blood pressure is usually at around 120 over 70. Think I'm having a little anxiety over this. I'll keep checking my blood pressure. Thank you.
Expert:  Dr. D. Love replied 1 year ago.
Yes, the anxiety could be causing the increase in blood pressure, but transient increases in blood pressure from anxiety are not a problem, and at this time, the slight increase in blood pressure is a safety buffer for the accidental extra dose.