We examined the effects of small ingestions of sustained release calcium channel blockers (SR-CCBs) in young children and characterized current recommendations regarding monitoring after a suspected ingestion. A 2-part study was performed of pediatric calcium channel blocker (CCB) ingestion: first a telephone survey of 33 randomly selected Poison Control Centers (PCCs) from around the US concerning their recommended management of a small ingestion of sustained release calcium channel blocker in a child, and then a 5-y retrospective review of local cases of CCB ingestions in children under 4 y-of-age. The number of hours of medical observation recommended by the PCCs varied from > or = 24 h (n = 15, 45%) to < 6 h (n = 6, 18%). The retrospective chart review revealed that 19 of 29 local cases involved a SR-CCB, and 6 of these were thought to have ingested only 1 tablet. Observation time varied from > 24 h to < 6 h in the 17 cases seen in an emergency department. No symptoms or vital sign abnormalities were reported in any case. Recommendations regarding duration of observation varied from < 6 h to 24 h. Ingestion of a few SR-CCB tablets was not associated with symptoms, suggesting that admission and 24-h monitoring may not be necessary under those circumstances.