Antidote: octreotide
Octreotide blocks the secretion of insulin by the pancreas, which blocks the effect of sulfonylurea drugs. For all patients with hypoglycaemia due to sulfonylurea poisoning, use:
1 octreotide 50 micrograms (child: 2 micrograms/kg up to 50 micrograms) subcutaneously, every 8 hours for at least 24 hours sulfonylurea poisoning octreotide
OR
2 octreotide 50 micrograms (child: 2 micrograms/kg up to 50 micrograms) intravenously, followed by 25 micrograms/hour (child: 1 microgram/kg/hour up to 25 micrograms/hour) by intravenous infusion for at least 24 hours. octreotide
The duration of octreotide therapy depends on the sulfonylurea drug ingested, the dose ingested, the time of ingestion (day or night), the patient’s ability to eat, and their kidney function. Stop octreotide in daylight hours and then measure the patient’s blood glucose concentration regularly for a further 12 hours.
If the response to octreotide therapy is inadequate (ie the patient is still hypoglycaemic), consider treatment with an intravenous glucose infusion (see Insulin poisoning / Subsequent glucose infusion for dosage).