Diazoxide

Diazoxide is a prescription medication used for the treatment of hypoglycemia.

• Diazoxide is available under the following different brand names: Proglycem

Adult and pediatric dosage

Oral suspension

• 50mg/mL

Hypoglycemia

Adult dosage

• 3 mg/kg/day orally divided every 8-12 hours initially; typical dose range 3-8 mg/kg/day

Pediatric dosage

• Newborn/infant: 10 mg/kg/day orally divided every 8 hours initially; typical dosage range is 8-15 mg/kg/day orally divided every 8-12 hours (also see Cautions regarding suspected pulmonary hypertension in newborns and infants)
• Children: 3 mg/kg/day orally divided every 8 hours initially; typical dose range is 3-8 mg/kg/day orally divided every 8-12 hours 

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Diazoxide include:

• nausea, 
• vomiting, 
• loss of appetite, 
• stomach pain or upset, 
• diarrhea,
• changes in sense of taste,
• temporary increase in growth of body hair (especially in women and children),
• headache,
• dizziness,
• anxiety, 
• weakness, or 
• itching or skin rash.

Serious side effects of Diazoxide include:

• blurred vision, tunnel vision, eye pain, or seeing halos around lights,
• breathing problems in an infant or newborn treated with diazoxide,
• shortness of breath (even with mild exertion), swelling, rapid weight gain,
• a light-headed feeling, or
• signs of high blood sugar (hyperglycemia) such as increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.

Rare side effects of Diazoxide include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Diazoxide has severe interactions with no other drugs.
• Diazoxide has serious interactions with no other drugs:
• Diazoxide has moderate interactions with the following drugs:
  • amifostine
  • atazanavir
  • benazepril
  • captopril
  • darunavir
  • fosamprenavir
  • hydrochlorothiazide
  • indinavir
  • insulin degludec
  • insulin degludec/insulin aspart
  • insulin inhaled
  • lopinavir
  • metformin
  • nelfinavir
  • ritonavir
  • saquinavir
  • tesamorelin
  • tipranavir
• Diazoxide has minor interactions with the following drugs:
  • bendroflumethiazide
  • chlorothiazide
  • chlorthalidone
  • cyclopenthiazide
  • ethotoin
  • fosphenytoin
  • hydralazine
  • hydrochlorothiazide
  • indapamide
  • methyclothiazide
  • metolazone
  • phenytoin

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to diazoxide, thiazides, or sulfonamide derivatives

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Diazoxide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Diazoxide?”

Cautions

• Use caution in coronary or cerebral insufficiency, DM, extravasation, heart failure (may increase fluid retention), cardiovascular insufficiency, gout, hypotension, hypokalemia, liver disease, renal dysfunction
• Pregnancy
• Compensatory HTN (aortic coarctation, arteriovenous shunt)
• Ineffective in pheochromocytoma
• Nonketotic hyperosmolar coma may occur during treatment; transient cataracts reported
• May displace bilirubin from albumin; use caution in newborns with hyperbilirubinemia
• The antidiuretic property of diazoxide may lead to significant fluid retention, which in patients with compromised cardiac reserve, may precipitate congestive heart failure; the fluid retention will respond to conventional therapy with diuretics
• Concomitantly administered thiazides may potentiate the hyperglycemic and hyperuricemic actions of diazoxide
• Ketoacidosis and nonketotic hyperosmolar coma were reported in patients treated with recommended doses usually during intercurrent illness; prompt recognition and treatment are essential and prolonged surveillance following the acute episode is necessary because of the long drug half-life of approximately 30 hours; occurrence of these serious events may be reduced by careful education of patients regarding monitoring urine for sugar and ketones and for prompt reporting of abnormal findings and unusual symptoms to a healthcare provider
• Effects of diazoxide on the hematopoietic system and the level of serum uric acid kept in mind; the latter should be considered particularly in patients with hyperuricemia or a history of gout
• The antihypertensive effect of other drugs may be enhanced by diazoxide; should keep this in mind when administering it concomitantly with antihypertensive agents
• Because of protein binding, administration of diazoxide with coumarin or its derivatives may require a reduction in the dosage of anticoagulants
• Pulmonary hypertension in newborns and infants
• July 16, 2015: FDA warns clinicians to watch for signs of pulmonary hypertension in infants treated for hypoglycemia with diazoxide and discontinue the drug if symptoms appear
• There have been 11 cases identified since the drug was approved (1973) and once diazoxide was discontinued, the symptoms resolved
• Signs of respiratory distress include flaring nostrils, grunting, unusual chest movements, rapid breathing, difficulty feeding, or a bluish tint to the lips or skin
• Monitoring is especially important for infants who have other risk factors for pulmonary hypertension (eg, meconium aspiration syndrome, respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, sepsis, congenital diaphragmatic hernia, and congenital heart disease)

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy
• Lactation
  • Excretion in milk unknown; not recommended