Use with caution in patients with known drug sensitivities. Adverse reactions may be due to high plasma levels as a result of excessive and rapid absorption of the drug. A small number of reactions may result from hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. Tremors and eventually clonic-tonic convulsions may result. Emesis may occur.
Central stimulation is followed by depression, with death resulting from respiratory failure.
Small doses of cocaine slow the heart rate, while moderate doses, increase the heart rate due to central sympathetic stimulation. Cocaine is pyrogenic, augmenting heat production by stimulating muscular activity and causing vasoconstriction which decreases heat loss. Cocaine is known to interfere with the uptake of norepinephrine by adrenergic nerve terminals, producing sensitization to catecholamines, causing vasoconstriction and mydriasis. Cocaine produces sloughing of the corneal epithelium, resulting in clouding, pitting and occasionally ulceration of the cornea. The drug is not meant for ophthalmic use.