Severe hypoglycaemia from non-prescription erection-booster drugs

[Guest guest]

Hi All, especially elderly males!

 

This abstract describes an outbreak of severe hypoglycaemia in HK

males who used non-prescription erection-boosting drugs - sildenafil

products containing glibenclamide.

 

Note: Sildenafil and glibenclamide belong to different drug groups

with different indications and have never been used in the same

formulation. Here we present the first cluster of hypoglycaemia cases

after taking non-prescription products containing both sildenafil and

glibenclamide. The recommended therapeutic dosages of glibenclamide

and sildenafil are 2.5-15 mg daily and 25-100 mg daily, respectively.

Quantitative analysis of the 25 unused capsules/tablets revealed a

glibenclamide content of 70 (0-158) mg per product. ONE such

capsule/tablet can cause intractable hypoglycaemia and lead to

permanent neurological damage or death. In some of the products, the

sildenafil content was subtherapeutic (many were <10 mg). Individuals

might take more than one capsule or tablet to obtain the desired

effect, thus dramatically increasing the extent of overdosing. The

full text is at http://www.hkmj.org/article_pdfs/hkm0906p196.pdf

 

Poon WT, Lam YH, Lee HC, Ching CK, Chan WT, Chan SS, Lai CK, Tse ML,

Chan YW, Mak WL. Outbreak of hypoglycaemia: sexual enhancement

products containing oral hypoglycaemic agent. Hong Kong Med J

2009;15:196-200. Hospital Authority Toxicology Reference Laboratory,

Princess Margaret Hospital, Laichikok, HK. Objectives: To describe a

cluster of HK subjects with hypoglycaemia, after they had taken

various non-prescription sildenafil products containing

glibenclamide. Design: Retrospective study. Setting: A tertiary

referral centre for clinical toxicology analysis in Hong Kong.

Patients: All men referred to the laboratory for investigation of

suspected drug-induced hypoglycaemia from December 2007 to September

2008. Main outcome measures: The characteristics of these patients,

including their clinical presentations, outcomes, drug history, urine

toxicology analysis results, and in some instances, analysis results

of unused products. Results: A total of 144 males were referred for

suspected drug-induced hypoglycaemia. Sildenafil and glibenclamide,

or their metabolites, were detected in the urine specimens of 68

(47%) patients, none of whom had been prescribed either drug by a

registered medical practitioner. Among these subjects, 24 (35%)

denied any use of sexual enhancement products despite repeated

questioning. 8 patients had repeated exposure resulting in re-

admission. The sources of these sexual enhancement products included

pharmacies in Mainland China, friends, local pharmacies, peddlers, or

were unknown. Three patients died, one remains in a vegetative state

and one suffered cognitive impairment; the remaining 63 recovered

fully. 25 unused sexual enhancement products of 7 different kinds

were recovered for analysis. The median (range) of sildenafil and

glibenclamide per unit dose was 64 (0.05-198) mg and 70 (0-158) mg,

respectively. Conclusion: These illegal products pose a severe and

continued threat to society and therefore deserve widespread

vigilance, so that such products can be eradicated at their source.

 

Best regards,