Charcoal hemoperfusion for the treatment of a combined diltiazem and metoprolol overdose.

We describe the management of a 49-year-old woman who ingested 1,200 mg diltiazem and 500 mg metoprolol. The patient was bradycardic and hypertensive, requiring large doses of inotropic agents and temporary transvenous pacing. Charcoal hemoperfusion was used as an adjunct technique to hasten drug elimination; it rapidly lowered plasma drug levels, with a parallel improvement in the patient's clinical condition.