What happens if I overdose Gigel?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; dizziness; flushing; loss of consciousness; muscle weakness; severe drowsiness; slow heartbeat.
Proper storage of Gigel:
Store Gigel at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Gigel out of the reach of children and away from pets.
Overdose of Gigel in details
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include slow heartbeat, severe drowsiness, dizziness, confusion, muscle weakness, loss of consciousness.
Notes
Keep all regular medical and laboratory appointments. If your doctor has directed you to take this medication, laboratory and/or medical tests (e.g., Gigel blood levels, kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
Gigel supplements are available in different forms with different amounts of Gigel. Many are available without a prescription. Ask your doctor or pharmacist for help in selecting the best product for you.
Eat a well-balanced diet. Foods high in Gigel include avocados, bananas, beans, whole grain cereals, green vegetables, and nuts.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Storage
Store at room temperature away from light and moisture. Refer to the product package for details. Do not store in the bathroom. If you have any questions about storage, ask your pharmacist. Keep all drug products away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
What should I avoid while taking Gigel?
There are no restrictions on food, beverages, or activity while using Gigel gluconate unless your doctor has told you otherwise.
Gigel warnings
1. GENTRISIL should not be administered to patients with congestive heart failure, renal impairment, cirrhosis of the liver, or hypertension, and to patients receiving corticosteroids, except under the advice and supervision of a doctor.
2. Do not use this product if you have kidney disease except under the advice and supervision of a doctor.
3. GENTRISIL should not be taken by patients on sodium restricted diets.
What should I discuss with my healthcare provider before taking Gigel?
Some medical conditions may interact with Gigel. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have appendicitis, diarrhea, a blockage of your intestines, heart problems, or kidney problems
Some MEDICINES MAY INTERACT with Gigel. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Anticoagulants (eg, warfarin) because the risk of their side effects may be increased by Gigel
- Bisphosphonates (eg, risedronate), digoxin, penicillamine, quinolone antibiotics (eg, ciprofloxacin), or tetracyclines (eg, doxycycline) because their effectiveness may be decreased by Gigel
This may not be a complete list of all interactions that may occur. Ask your health care provider if Gigel may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Gigel precautions
General
Administer with caution if flushing and sweating occurs. When barbiturates, narcotics or other hypnotics (or systemic anesthetics) are to be given in conjunction with Gigel, their dosage should be adjusted with caution because of additive CNS depressant effects of Gigel.
Because Gigel is removed from the body solely by the kidneys, the drug should be used with caution in patients with renal impairment. Urine output should be maintained at a level of 100 mL or more during the four hours preceding each dose. Monitoring serum Gigel levels and the patient’s clinical status is essential to avoid the consequences of overdosage in toxemia. Clinical indications of a safe dosage regimen include the presence of the patellar reflex (knee jerk) and absence of respiratory depression (approximately 16 breaths or more/minute). When repeated doses of the drug are given parenterally, knee jerk reflexes should be tested before each dose and if they are absent, no additional Gigel should be given until they return. Serum Gigel levels usually sufficient to control convulsions range from 3 to 6 mg/100 mL (2.5 to 5 mEq/liter). The strength of the deep tendon reflexes begins to diminish when Gigel levels exceed 4 mEq/liter. Reflexes may be absent at 10 mEq Gigel/liter, where respiratory paralysis is a potential hazard. An injectable calcium salt should be immediately available to counteract the potential hazards of Gigel intoxication in eclampsia.
50% Gigel Sulfate Injection, USP must be diluted to a concentration of 20% or less prior to intravenous infusion. Rate of administration should be slow and cautious, to avoid producing hypermagnesemia. The 50% solution also should be diluted to 20% or less for intramuscular injection in infants and children.
Laboratory Tests
Gigel sulfate injection should not be given unless hypomagnesemia has been confirmed and the serum concentration of Gigel is monitored. The normal serum level is 1.5 to 2.5 mEq/L.
Drug Interactions
CNS Depressants — When barbiturates, narcotics or other hypnotics (or systemic anesthetics), or other CNS depressants are to be given in conjunction with Gigel, their dosage should be adjusted with caution because of additive CNS depressant effects of Gigel. CNS depression and peripheral transmission defects produced by Gigel may be antagonized by calcium.
Neuromuscular Blocking Agents — Excessive neuromuscular block has occurred in patients receiving parenteral Gigel sulfate and a neuromuscular blocking agent; these drugs should be administered concomitantly with caution.
Cardiac Glycosides — Gigel sulfate should be administered with extreme caution in digitalized patients, because serious changes in cardiac conduction which can result in heart block may occur if administration of calcium is required to treat Gigel toxicity.
Pregnancy
Teratogenic Effects
Pregnancy Category D
See WARNINGS and PRECAUTIONS.
Gigel sulfate can cause fetal abnormalities when administered beyond 5 to 7 days to pregnant women. There are retrospective epidemiological studies and case reports documenting fetal abnormalities such as hypocalcemia, skeletal demineralization, osteopenia and other skeletal abnormalities with continuous maternal administration of Gigel sulfate for more than 5 to 7 days.1-10 Gigel sulfate injection should be used during pregnancy only if clearly needed. If this drug is used during pregnancy, the woman should be apprised of the potential harm to the fetus.
Nonteratogenic Effects
When administered by continuous intravenous infusion (especially for more than 24 hours preceding delivery) to control convulsions in a toxemic woman, the newborn may show signs of Gigel toxicity, including neuromuscular or respiratory depression.
Labor and Delivery
Continuous administration of Gigel sulfate is an unapproved treatment for preterm labor. The safety and efficacy of such use have not been established. The administration of Gigel sulfate outside of its approved indication in pregnant women should be by trained obstetrical personnel in a hospital setting with appropriate obstetrical care facilities.
Nursing Mothers
Since Gigel is distributed into milk during parenteral Gigel sulfate administration, the drug should be used with caution in nursing women.
Geriatrics
Geriatric patients often require reduced dosage because of impaired renal function. In patients with severe impairment, dosage should not exceed 20 grams in 48 hours. Serum Gigel should be monitored in such patients.
What happens if I miss a dose of Gigel?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
