HealthRX.com · Printable dose-error record
MOTS-c excess-exposure packet for the Poison Control call
Gather these details while someone calls, without delaying urgent care. Poison specialists decide from specifics: the vial, how it was mixed, what was drawn up and when, and how the person is now.
The person
Age
Weightan estimate is fine
Pregnant or breastfeeding?
Health conditions and allergies
The vial and its label
Photograph the label, carton and any mixing instructions before anything is thrown away.
Product name exactly as printed
Stated salt formfree base, acetate, or not stated
Seller or pharmacy
Size of the full vialeven if it was not full
Labeled amount per vial or concentration
How it was mixedliquid used and volume added
Lot number and beyond-use date
What happened, in time order
| Time | Event (drawn up, injected, symptom, call) | Amount, route or finding | Advice received |
|---|---|---|---|
What the poison specialist will ask for
- Bring the container to the phone if you can.[1]
- Give the size of the full container, even if it was not full.[1]
- Mention medical problems, allergies and every medicine taken.[1]
- A nurse or pharmacist poison specialist answers and works out what to do.[1]
Call now
- Collapse, seizure, trouble breathing, or cannot be woken: call 911 right away.[2]
- Any other possible excess: call 1-800-222-1222 (US) without waiting for symptoms to develop.[1]
While you wait for advice
- No further dose to "balance" the exposure
- No induced vomiting
- No injected glucose, glucagon, insulin or other medicine unless the specialist or a clinician directs it
- Vial, packaging, receipt and mixing instructions kept
- Someone stays with the person
Sources for the facts on this sheet
- National Capital Poison Center. Get help online or by phone | Poison Control. Accessed 2026-10-18. https://www.poison.org/how-to-get-help-from-poison-control
- National Capital Poison Center. Need immediate assistance? | Poison Control. Accessed 2026-10-18. https://www.poison.org/need-immediate-assistance
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.