What is an accidental overdose of medicine?

Taking too much medicine is known as an overdose. More Australians are dying from accidental overdoses than ever before. Overdosing can be very dangerous, and even life-threatening. But accidental overdoses can be prevented.

Most medicines have some side effects or can increase your chance of harm if you use them incorrectly. If you use medicine correctly, in the right doses (amounts) to treat the right problems, they can be safe and beneficial.

How can accidental overdose happen?

Most medicines are toxic (harmful) if you take too much. The more medicines you take, the higher your chance of harm from them.

You have a higher chance of accidental overdose if:

• you are taking a combination of different medicines
• you don't follow the instructions of your doctor or pharmacist
• you mix medicine with alcohol or other drugs
• An accidental overdose can also happen if you take a medicine by mistake.

It's always important to read the label, even if you have taken the medicine before.

Taking too much medicine

Some medicines contain the same active ingredient but have different brand names.

Taking more than one medicine with the same active ingredient can cause an overdose. For example, 2 pain relief medicines might have different names but both contain paracetamol. This means you will receive 2 times the dose.

Strength

Taking medicine that is stronger than you thought can cause an overdose.

Medicines with the same brand name may come in different strengths. This means that a tablet in one package may contain a higher dose of medicine than a tablet in a different package. Always read the instructions on a packet so you know how much medicine to take.

Measuring

Using the wrong measuring device for the medicine can also lead to an overdose.

Overdose in children

Your child has a higher chance of accidental overdose if you incorrectly calculate your child's medicine dose based on their weight.

Children can also accidentally overdose if you don't store a medicine safely. This means that they can reach the medicine and accidentally swallow it.

What are the symptoms of an overdose of medicine?

The symptoms of a medicine overdose depend on the type of medicine you’ve taken.

If someone has overdosed, they may:

• appear to be confused
• have blue lips or fingertips
• have cool, clammy skin
• have very small, pinpoint-sized pupils
• have a seizure
• appear to be unconscious, can't be woken up, is snoring or gurgling
• be not breathing, or have shallow breathing

If your child has had too much medicine, they may:

• vomit (be sick)
• become tired
• show signs of anaphylaxis (an allergic reaction)

How can I reduce my chance of an accidental overdose?

Make sure you understand which medicines you’re taking and how to take them. Always follow any instructions from your doctor or pharmacist.

It’s very important to store medicines correctly and always keep medicines out of the reach of children.

There are some things you can do to reduce your chance of an overdose:

• Always read the medicine label and consumer medicine information (CMI) leaflet.
• Find out which medicines can be taken together, and which need to be taken at different times.
• Keep track of which medicines you’ve taken, and how much you’ve taken.
• Always measure the medicine accurately — take special care when measuring medicine for children.
• Only take medicine that has been prescribed for you — never take someone else's medicine.
• Find out if it’s safe to drink alcohol with the medicines you are taking.
• Talk to your pharmacist about managing your medicines safely, or to organise a Home Medicines Review.

Which medicines do I need to be most careful of?

It’s important to be careful with all medicines, but some are more dangerous or than others.

Opioids

Opioids include strong pain medicines such as:

• codeine
• fentanyl
• oxycodone

Opioids are the most common cause of fatal accidental overdoses in Australia. Your chance of harm is higher if you are also:

• drinking alcohol
• taking benzodiazepines (such as diazepam and alprazolam)
• taking antidepressants
• taking antipsychotics
• Paracetamol

Paracetamol is the one of the most common causes of people being admitted to hospital for accidental overdose. Paracetamol is also one of the most common causes of accidental overdose in children.

Taking too much paracetamol can lead to:

• yellow eyes and skin (jaundice)
• loss of coordination
• liver damage
• death

If you think you or your child have taken too much paracetamol, get help quickly. This is because the damage to your liver can happen even before you notice any symptoms.

Benzodiazepines

Benzodiazepines, such as diazepam and temazepam, are the second most common cause of accidental overdoses resulting in death. Benzodiazepines are involved in many deaths that happen when multiple drugs are combined.

The chance of harm from benzodiazepines is higher if they are taken with:

• alcohol
• opioids
• some over-the-counter medicines
• Diabetes medicine

If you have diabetes, you can overdose on diabetes medicine. Taking too much insulin or other diabetes medicines can cause hypoglycaemia (your blood sugar level to drop too low). This can develop into a serious situation. If you have diabetes, ask your doctor or diabetes educator what to do if this happens to you.

It’s also dangerous for people who don’t have diabetes to take these medicines.

What should I do if someone has overdosed?

If someone has taken a medicine and is unresponsive, don't assume they are just asleep. An overdose is a medical emergency.

While waiting for the ambulance, follow these steps:

1. Stay with the person who has overdosed.
2. Lie them on their side.
3. Talk to them and try to keep them awake, if they’re conscious.
4. Loosen any tight clothes.
5. Open a window or take them outside for air.
6. Be aware that they may need CPR.

If you are worried that someone has taken the wrong type or amount of medicine, call the Poisons Information Hotline on 13 11 26 for guidance.

How is an overdose treated?

Treatment of an overdose depends on the type of medicine taken.

The Take Home Naloxone Program

Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. The Take Home Naloxone Program is funded by the Australian Government. This program makes naloxone free and without a prescription to anyone who might experience or witness an opioid overdose.

Learn more about the Take Home Naloxone program.

Resources and support

For information about prescription, over-the-counter and complementary medicines, you can call 1300 MEDICINE on 1300 633 424.

The Alcohol and Drug Foundation can also provide information and support. Visit the website or call the National Alcohol and Other Drug Hotline on 1800 250 015.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.