Diazoxide

General

• Type: Antihypertensive, hyperglycemic
• Routes of administration: PO, IV (discontinued in US)

• Non-diuretic thiazide, arterial vasodilator
• Used to treat severe hypertension
• Reflex response leads to tachycardia and increased cardiac output

Adult Dosing

• 1-3 mg/kg IV (maximum 150 mg)
• 3-8 mg/kg/day PO divided into 2-3 doses

Pediatric Dosing

• 3-8 mg/kg/day PO divided into 2-3 doses

Special Populations

• Pregnancy: C
• Lactation: Infant risk cannot be ruled out
• Renal Dosing: reduce dose
• Hepatic Dosing:

Contraindications

• Allergy to class/drug
• Functional hypoglycemia
• Aortic stenosis, aortic coarctation
• Hypertrophic cardiomyopathy

Adverse Effects

Serious

• CHF, MI
• Pulmonary hypertension
• Fluid retention
• DKA, HHS, hyperglycemia
• Hypernatremia
• Bowel obstruction
• Pancreatitis
• Thrombocytopenia
• Cataract

Common

• Hypotension
• Palpitations, tachycardia
• Dizziness, asthenia
• Hyperglycemia, glycosuria, increased uric acid level
• Hirsutism
• Abdominal pain, nausea/vomiting, diarrhea, anorexia
• Neutropenia

Interactions

• May potentiate warfarin's anticoagulant effects

Pharmacology

• Half-life: 20-36 hours
• Metabolism: hepatic
• Excretion: Renal

==Mechanism of Action

• Hyperglycemic: inhibits pancreatic insulin release
• Antihypertensive: arteriolar vasodilation and decreased peripheral resistance

References

Olson, K. Poisoning and Drug Overdose, 1999 Epocrates