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