UMEM Educational Pearls

Category: Toxicology

Title: Sulfonylureas - What is the antidote?

Keywords: sulfonylureas, octreotide, hypoglycemia (PubMed Search)

Posted: 11/8/2007 by Fermin Barrueto, MD (Updated: 7/10/2020)
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Sulfonylureas

  • Sulfonylureas cause insuline release via cAMP/protein kinase C
  • All sulfonylurea overdoses should be admitted for 24 hrs regardless of symptoms
  • Antidote for recurrent hypoglycemia due to sulfonylureas (overdose or therapeutic misadventure) is octreotide, after your glucose
  • Octreotide, a somatostatin analogue, turns of insulin secretion completely
  • Octreotide 50 mcg SQ q 6 hrs for 24 hrs then observe for hypoglycemia 12-24 hrs

Fasono et al. Comparison of Octreotide and Standard Therapy Versus Standard Therapy Alone for the Treatment of Sulfonylurea-Induced Hypoglycemia. Ann Emerg Med 2007 Aug 29.