Amaryl Overdosage

Amaryl overdose as well as long-term treatment with too high a dose may lead to severe and sometimes life-threatening hypoglycaemia and may require hospitalization even as a precautionary measure.
As soon as an overdose of Amaryl has been discovered, a physician must be notified without delay. The patient must immediately take sugar, if possible in the form of glucose, unless a physician has already undertaken responsibility for treating the overdose.
Careful monitoring is essential until the physician is confident that the patient is out of danger. It must be remembered that hypoglycaemia may recur after initial recovery.
Mild episodes of hypoglycaemia can usually be treated with oral carbohydrates. Adjustments in dosage, meal patterns or physical activity may be necessary.
More severe episodes with loss of consciousness, coma, seizure or other serious neurologic impairment are medical emergencies and will necessitate immediate treatment and hospitalization which may be treated with glucagons (intramuscular or subcutaneous) or concentrated glucose solution (intravenous).
If, for example, the patient is unconscious, an intravenous injection of concentrated glucose solution is indicated (for adults starting with 40 ml of 20% solution, for example). Alternatively in adults, administration of glucagon, e.g. in doses of 0.5 to 1 mg i.v., s.c. or i.m., may be considered.
In particular when treating hypoglycaemia due to accidental intake of Amaryl in infants and young children, the dose of glucose given must be very carefully adjusted in view of the possibility of producing dangerous hyperglycaemia, and must be controlled by close monitoring of blood glucose.
If life-threatening amounts have been ingested, detoxification (by, e.g., gastric lavage, activated charcoal) will be necessary.
Sustained administration of carbohydrates and observation may be necessary because hypoglycaemia may recur after apparent clinical recovery.
After acute glucose replacement has been completed it is usually necessary to give an intravenous glucose infusion in lower concentration so as to ensure that the hypoglycaemia does not recur. The patient's blood glucose level should be carefully monitored for at least 24 hours. In severe cases with a protracted course, hypoglycaemia, or the danger of slipping back into hypoglycaemia, may persist for several days.