Glucotrol XL

[Glipizide]

Overdosage & Contraindications
CONTRAINDICATIONS

Glipizide is contraindicated in patients with:

1. Known hypersensitivity to the drug.

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2. Diabetic ketoacidosis, with or without coma. This condition should be treated with insulin.

OVERDOSAGE

There is no well-documented experience with GLUCOTROL XL overdosage in humans. There have been no known suicide attempts associated with purposeful overdosing with GLUCOTROL XL. In nonclinical studies the acute oral toxicity of glipizide was extremely low in all species tested (LD50 greater than 4 g/ kg). Overdosage of sulfonylureas including glipizide can produce hypoglycemia.

Mild hypoglycemic symptoms without loss of consciousness or neurologic findings should be treated aggressively with oral glucose and adjustments in drug dosage and/ or meal patterns. Close monitoring should continue until the physician is assured that the patient is out of danger. Severe hypoglycemic reactions with coma, seizure, or other neurological impair-ment occur infrequently, but constitute medical emergencies requiring immediate hospitalization.

If hypoglycemic coma is diagnosed or suspected, the patient should be given rapid intravenous injection of concentrated (50%) glucose solution. This should be followed by a continuous infusion of a more dilute (10%) glucose solution at a rate that will maintain the blood glucose at a level above 100 mg/ dL. Patients should be closely monitored for a minimum of 24 to 48 hours since hypoglycemia may recur after apparent clinical recovery. Clearance of glipizide from plasma may be prolonged in persons with liver disease. Because of the extensive protein binding of glipizide, dialysis is unlikely to be of benefit.