Overdose: The main manifestation of acute overdose with repaglinide is hypoglycemia.
Treatment: Symptoms of hypoglycemia without loss of consciousness or neurotoxicity: Immediately give glucose and adjust the dosage and/or diet. The patient should be closely monitored for at least 24 to 48 hours, because hypoglycemia may recur after apparent clinical recovery. There is no evidence that repaglinide is removed by hemodialysis.
Severe hypoglycemia with coma, seizures or neurological deficits rarely occurs and requires immediate emergency treatment and hospitalization. If the patient is diagnosed or suspected of having coma due to hypoglycemia, administer a rapid intravenous injection of glucose solution (50%). Then continue to infuse a more dilute glucose solution (10% concentration) at a rate that can maintain blood glucose concentration above 100 mg/dL.