Diazoxide

Diazoxide Reviews, Dosing Hack, Uses, Side Effects & more

Diazoxide is a medication used to treat low blood sugar (hypoglycemia) caused by certain medical conditions such as insulinoma or congenital hyperinsulinism.

 

What is Diazoxide?

  • Type: Non-diuretic benzothiadiazine derivative (chemically related to thiazides but lacks diuretic effects).

  • Primary Use: Manages hypoglycemia (low blood sugar) caused by:

    • Pancreatic tumors (e.g., insulinoma), surgery, or congenital hyperinsulinism.

    • Off-label: Hyperphagia in Prader-Willi syndrome (extended-release diazoxide choline, approved 2025).

  • Mechanism:

    • Opens ATP-sensitive potassium channels (KATP) in pancreatic beta-cells → inhibits insulin release.

    • Additional effect: Vasodilation (historically used for hypertensive emergencies, but IV form discontinued in the US).

 

Available Formulations

Form Key Features
Oral Suspension Shake well before use; measure with provided dropper. Avoid freezing.
Extended-Release Capsules Swallow whole; do not crush/chew. Approved for Prader-Willi syndrome (2025).

 

Critical Safety Considerations

Contraindications

  • Functional hypoglycemia (not caused by excess insulin).

  • Hypersensitivity to diazoxide or sulfonamides.

Use with Caution in

  • Cardiac conditions: Heart failure, pulmonary hypertension (↑ risk of fluid retention).

  • Renal impairment: Slows drug clearance → ↑ risk of toxicity (dose adjustment needed).

  • Gout/hyperuricemia: Diazoxide ↑ uric acid levels.

  • Hepatic impairment (e.g., bilirubinemia).

Black Box Warning

  • Pulmonary hypertension reported in infants/neonates (monitor for respiratory distress).

 

Drug Interactions

Interaction Type Examples Risk
Avoid Combination Isocarboxazid (MAOI) Hypertensive crisis.
High-Risk Combinations Diuretics (e.g., bumetanide, hydrochlorothiazide), NSAIDs (e.g., aspirin), Anticoagulants (e.g., warfarin) ↑ Fluid retention, hyperglycemia, or bleeding risk.
Food Interactions Caffeine

💡 Always disclose all medications/supplements to your prescriber.

 

Dosing & Administration

  • Dose: Weight-based (starting dose):

    • Adults/Children: 3–8 mg/kg/day divided every 8–12 hours.

    • Infants/Newborns: 8–15 mg/kg/day divided every 8–12 hours.

  • Key Instructions:

    • Take at the same time daily.

    • Monitor blood glucose/urine ketones regularly.

    • Follow prescribed diet (critical for efficacy).

  • Missed Dose: Take ASAP; skip if close to next dose (never double dose).

 

Side Effects

Common (≥10%) Serious (Require Immediate Care)
Hirsutism (excessive hair growth) Pulmonary hypertension: Shortness of breath, chest pain
GI Upset: Nausea, taste changes Severe hyperglycemia: Drowsiness, fruity breath, thirst, frequent urination
Fluid retention (edema) Blood disorders: Unexplained bruising/bleeding, fever
Hyperuricemia (↑ gout risk) Allergic reactions: Rash, blistering, mouth sores

 

Special Populations

  • Pregnancy/Breastfeeding: Avoid (no safety data; potential fetal harm).

  • Geriatrics: Use cautiously (age-related renal decline).

  • Pediatrics: Safe but monitor for fluid retention/pulmonary hypertension.

 

Monitoring Requirements

  • Blood glucose (frequent checks to avoid hyperglycemia).

  • Renal/hepatic function, electrolytes, uric acid.

  • Fluid status (weight, edema signs).

  • Cardiopulmonary symptoms (especially in infants).

 

Storage & Handling

  • Store: At room temperature, protected from light/moisture.

  • Oral suspension: Do not freeze; shake well before use.

  • Disposal: Return unused medication to healthcare provider.

 

Key Patient Counseling Points

  1. Never skip glucose monitoring – report hyperglycemia symptoms (drowsiness, thirst) immediately.

  2. Take exactly as prescribed – do not switch formulations without approval.

  3. Avoid caffeine and disclose all other medications.

  4. Report fluid retention (swelling, rapid weight gain) or breathing difficulties urgently.

  5. Expect hair growth changes – reversible after discontinuation.

For full prescribing details, consult the FDA label or your healthcare provider.