Glubitor/Glubitor-OD Overdosage

Glubitor/Glubitor-OD (PR tab): Symptoms: An overdose of sulfonylureas may cause hypoglycemia.
Moderate symptoms of hypoglycemia, without any loss of consciousness or neurological signs, must be corrected by carbohydrate intake, dose adjustment and/or change of diet. Strict monitoring should be continued until the doctor is sure that the patient is out of danger.
Severe hypoglycemic reactions, with coma, convulsions or other neurological disorders are possible and must be treated as a medical emergency, requiring immediate hospitalization.
Management: If a hypoglycemic coma is diagnosed or suspected, the patient should be given a rapid I.V. injection of 50 mL of concentrated glucose solution (20 to 30%). This should be followed by a continuous infusion of a more dilute glucose solution (10%) at a rate that will maintain blood glucose levels above 1 g/L. Patients should be monitored closely and, depending on the patient's condition after this time, the doctor will decide if further monitoring is necessary.
Dialysis is of no benefit to patients due to the strong binding of gliclazide to proteins.
Glubitor-OD (MR tab): Overdosage with gliclazide and other sulfonylureas will likely result in hypoglycemia which may need to be treated with intravenous infusion of 5% glucose for 12 to 14 hours with frequent monitoring of blood glucose level. Potassium levels should also be monitored. Cerebral edema may also need to be treated in unusually severe cases.
In comatose patients, glucagon injection may be administered before intravenous glucose therapy although this may induce vomiting. Efficacy of this treatment will also be dependent on hepatic glycogen status.
In severe sulfonylurea overdose, diazoxide and octreotide may reduce insulin secretion and hypoglycemia.
Continue frequent oral feeding and blood glucose and potassium monitoring until recovery.