Liverpool Hospital Emergency Department


  • Acute sulphyonylurea overdose
  • Use has been reported in massive venlafaxine overdose (sulphonylurea like effect) o Quinine induced hypoglycaemia 


  • In our ED 500mcg ampoules in the fridge (remove 1/10th to obtain 50mcg) o Can come in 50mcg ampoule 

Dosage and Administration 

  • Subcutaneous 50mcg 8 hourly (2mcg/kg up to 50mcg paediatrics)
  • Intravenous – 50mcg IV bolus (2mcg/ kg up to 50mcg paediatrics) followed by  infusion 25mcg/hr (1mcg/kg/hr paediatrics) 

Side Effects:

  • minor nausea 

Pit Falls:  

  • Perform serial blood glucose with aiming for concentration 4-8mmol. Baseline every  4 hours.
  • Perform BSL 30-60 minutely in symptomatic or hypoglycaemic patients until sugar  stable for 4 hours
  • Perform BSL every 2 hours in asymptomatic patients until BSL stable for 4 hours.
  • Ideally avoid repeated boluses of dextrose (will cause rebound hypoglycaemia due  to insulin release) unless there is inadequate response to octreotide (can consider a  dextrose infusion)
  • If able to eat – encourage complex carbohydrates
  • Cessation: Patient must be observed for at least 12 hours post cessation of  octreotide with normal diet to ensure no further hypoglycaemia