Case of fixed-dose combination antihypertensive medications, amlodipine and losartan, intoxication

Background: Fixed-dose combination (FDC) medications are increasingly utilized in clinical practice due to their convenience and potential benefits in improving adherence. However, reports on FDC intoxication remain uncommon, and management strategies for such cases are not well established. Case: A 19-year-old female presented to the emergency department (ED) six hours after intentionally ingesting 400 mg of amlodipine and 4000 mg of losartan, components of the combination drug Amosartan-Q, which also contains rosuvastatin. Despite intensive treatment, including inotropic agents, calcium gluconate, glucagon, hyperinsulinemic-hypoglycemic therapy, and continuous renal replacement therapy, her hemodynamic status continued to deteriorate. Approximately 54 hours after arrival, she suffered pulseless electrical activity (PEA) arrest and subsequently died. Conclusions: The management of FDC drug overdose remains poorly defined, and conventional therapies are often insufficient. This case highlights a significant gap in clinical understanding and underscores the need for further research and standardized treatment protocols for FDC intoxication.