Fatal amlodypine overdose: forensic and clinical features - a systematic review

Amlodipine is one of the basic drugs used in the treatment of hypertension. It belongs to the dihydropyridine calcium channel blocker and is one of the most frequently used drugs, which translates into its widespread use in the clinic and popularity. Amlodipine overdose may be associated with life-threatening complications, but fatal overdoses have not been well described and pose significant challenges in post-mortem diagnosis. The aim of the study was to analyze cases of fatal amlodipine overdose with particular attention to the circumstances of the events and the diagnostics performed. As a result of the literature review using relevant keywords and boolean operators, 13 articles were identified that met the study inclusion criteria. The articles included in the study were published between 1997 and 2024 and were mostly from Europe. There were 17 cases described, 9 of which were men. The average age in the group included in the study was 43.8 years. Most cases were suicidal overdoses, and the events usually occurred at home. The most common finding at autopsy was passive congestion and edema in the lungs. No specific histopathological findings were revealed except for the confirmation of autopsy gross findings. The most frequently analyzed material for toxicological tests to assess amlodipine content was blood. An important role in the assessment of cases of fatal overdose is the assessment of the place where the body was found. Due to the widespread availability of the drug, further research is needed on fatal overdose, especially regarding post-mortem diagnosis.