Reactions 1477, p30 - 9 Nov 2013 O S Sitagliptin overdose Various toxicities in an elderly patient: case report An 88-year-old woman developed renal impairment, hypotension, junctional bradycardia, corrected QT(c) interval prolongation after an overdose of sitagliptin. The woman, who had a history of diabetes mellitus, coronary heart disease and congestive heart failure, ingested 80 sitagliptin tablets (8000mg) in a suicide attempt. Dizziness and vomiting occurred, and she was found lying conscious on the floor 6 hours later. She was admitted to hospital, where hypotension (BP 80/40mm Hg) and bradycardia (HR 49 bpm) were observed. Renal impairment and mild metabolic acidosis were noted, along with hyperglycaemia. An ECG showed a junctional rhythm (HR 52 bpm), with a prolonged QTc interval of 496ms. The woman was administered IV fluids, SC insulin and a dopamine infusion. Her plasma creatinine level peaked at 246 µmol/L 48 hours after the overdose, before gradually recovering to 129 µmol/L. Her bradycardia and QTc prolongation also gradually resolved. A urine drug screen was positive for sitagliptin and its metabolites. Author comment: "We describe a case of hypotension, junctional bradycardia, QTc interval prolongation and renal impairment following acute overdose with sitagliptin." Chan JCM, et al. Hypotension, junctional bradycardia, QTC interval prolongation and renal impairment following acute overdose with sitagliptin. Clinical Toxicology 50: 365 abstr. 349, No. 4, Apr 2012. Available from: URL: http:// dx.doi.org/10.3109/15563650.2012.669957 - Hong Kong 803095414 1 Reactions 9 Nov 2013 No. 1477 0114-9954/13/1477-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved

Sitagliptin overdose

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Reactions 1477, p30 - 9 Nov 2013

O SSitagliptin overdose

Various toxicities in an elderly patient: case reportAn 88-year-old woman developed renal impairment,

hypotension, junctional bradycardia, corrected QT(c) intervalprolongation after an overdose of sitagliptin.

The woman, who had a history of diabetes mellitus,coronary heart disease and congestive heart failure, ingested80 sitagliptin tablets (8000mg) in a suicide attempt. Dizzinessand vomiting occurred, and she was found lying conscious onthe floor 6 hours later. She was admitted to hospital, wherehypotension (BP 80/40mm Hg) and bradycardia (HR 49 bpm)were observed. Renal impairment and mild metabolic acidosiswere noted, along with hyperglycaemia. An ECG showed ajunctional rhythm (HR 52 bpm), with a prolonged QTc intervalof 496ms.

The woman was administered IV fluids, SC insulin and adopamine infusion. Her plasma creatinine level peaked at246 µmol/L 48 hours after the overdose, before graduallyrecovering to 129 µmol/L. Her bradycardia and QTcprolongation also gradually resolved. A urine drug screen waspositive for sitagliptin and its metabolites.

Author comment: "We describe a case of hypotension,junctional bradycardia, QTc interval prolongation and renalimpairment following acute overdose with sitagliptin."Chan JCM, et al. Hypotension, junctional bradycardia, QTC interval prolongationand renal impairment following acute overdose with sitagliptin. ClinicalToxicology 50: 365 abstr. 349, No. 4, Apr 2012. Available from: URL: http://dx.doi.org/10.3109/15563650.2012.669957 - Hong Kong 803095414