Octreotide for sulfonylurea-induced hypoglycemia following overdose.
OBJECTIVE
To describe the use of octreotide in the management of 2 cases of sulfonylurea-induced hypoglycemia following overdose and to review the literature on the use of octreotide in the management of sulfonylurea overdose.


METHODS
Case 1 describes a 27-year-old woman who ingested 500 mg of glyburide; case 2 describes a 22-year-old woman following ingestion of glyburide 1000 mg. Despite administration of bolus doses of dextrose 50% and infusions of dextrose 10%, both patients demonstrated refractory hypoglycemia. Three doses of octreotide 50 micro g were administered subcutaneously spaced 8 hours apart to both patients, resulting in a reduction of hypoglycemic episodes and a reduced need for dextrose administration.


CONCLUSIONS
In addition to the 2 cases described, 8 citations involving 23 patients with sulfonylurea overdose in which octreotide was used were identified in the literature. As with our patients, episodes of hypoglycemia and the need for bolus doses of dextrose 50% were reduced following administration of octreotide.


CONCLUSIONS
The use of octreotide appears to reduce the number of hypoglycemic episodes and glucose requirements, with no reported toxicities associated with its use for sulfonylurea-induced hypoglycemia following overdose.
Carr
Roxane
R
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Zed
Peter J
PJ
D000328:Adult; D002986:Clinical Trials as Topic; D062787:Drug Overdose; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D013453:Sulfonylurea Compounds / Q000009:adverse effects*
D005765:Gastrointestinal Agents; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D015282:Octreotide