The management of overdose is an evolving science using symptomatic treatments based on the pharmacokinetic and toxicological profile of the drug taken. Advice on the management of some of the older drugs commonly used as a means of suicide is well considered, for example paracetamol and aspirin, and the relevant overdose sections of Summaries of Product Characteristics (SPCs) are continually being updated.
For the majority of marketed medicines, the advice on overdose continues to be based on practices in use at the time the marketing authorisation was granted. For example, the standard triple regimen for management of the immediate effects of self-poisoning used to be ipecacuanha, gastric lavage and enteral charcoal. Following consensus statements published by the American Academy and the European Association in 1997, ipecacuanha is contraindicated and gastric lavage hardly ever used. (Ipecacuanha has been withdrawn from the 'British National Formulary' (BNF).) However, the SPCs for many older drugs continue to recommend the triple regimen.