Antidiabetic Medications: Hypoglycemic Potential in Overdose

Sep 16, 14
Antidiabetic Medications: Hypoglycemic Potential in Overdose

antidiabetic medicationsWith several new diabetes medications available, it is important to know which ones are likely to cause hypoglycemia after overdose. Based on mechanism of action and reported cases, the likelihood of hypoglycemia after overdose is listed below by drug class. 1

Keep in mind that other drugs can interact with antidiabetic medications resulting in hypoglycemia. The following table applies only to single agent ingestion/administration.

Drug Class Examples Hypoglycemic Potential
Insulins Glargine, Aspart, Detemir High
Sulfonylureas Glyburide, Glipizide, Glimepiride High
Meglitinides Nateglinide, Repaglinide High
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Exenatide, Albiglutide, Liraglutide Low-Moderate
Alpha-glucosidase inhibitors Acarbose, Miglitol Low
Thiazolidinediones Rosiglitazone, Piaglitazone Low
Biguanides Metformin Low
Dipeptidyl Peptidase 4 (DPP-4) Inhibitors Sitagliptin, Saxagliptin, Linagliptin Low
Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors Canagliflozin Low
Adapted from a University of Maryland Emergency Medicine (UMEM, @UMEmergencyMed) Educational Pearl.

Image credit

1.
Nelson L, Lewin N, Howland M Ann, Hoffman R, Goldfrank L, Flomenbaum N. Antidiabetics and Hypoglycemics. In: Goldfrank’s Toxicologic Emergencies. 9th ed. New York: Mcgraw-Hill; 2010:714-727.

Author information

Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP

Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP

Leadership Team, ALiEM
Creator and Lead Editor, Capsules and EM Pharm Pearls Series
Attending Pharmacist, EM and Toxicology, MGH
Associate Professor of EM, Division of Medical Toxicology, Harvard Medical School

The post Antidiabetic Medications: Hypoglycemic Potential in Overdose appeared first on ALiEM.

Leave a Comment

Like articles like this one?

Join our Email List and get the latest TCCC/TECC/TEMS news bulletins, articles, product releases, and more!

Free Delivery

On all orders over $99 within CONUS and to APO/FPO

Easy Returns

We're here to help! Satisfaction Guaranteed

Knowledgeable Staff

Ready to assist you at a moment's notice

Safe& Secure Checkout

World’s most advanced and secure website encryption.