A dietary supplement may contain undeclared contents including pharmaceuticals. These can have adverse effects that the user does not expect.

Patient selection: male ingesting an over-the-counter supplement for male enhancement


Case definition:

(1) consumption of an over-the-counter male enhancement product within past 48 hours

(2) no history of insulin or other drug used to reduce blood glucose concentration

(3) severe hypoglycemia, which may be prolonged


Undeclared content: sildenafil, glyburide (sulfonylurea)


Antidote for the glyburide: octreotide


The patient would also be at risk from the sildenafil if he had contraindications to its use.

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