Diazoxide (oral)

Overview

When the pancreas produces and releases excess insulin, it prevents blood sugar from rising to normal levels. That is because insulin accelerates the absorption of sugar (in the form of glucose) into body cells. The job of diazoxide is to obstruct further secretion of the hormone, relieving the symptoms of hypoglycemia in a patient.

Diazoxide is a thiazide medication that can help ease symptoms such as nervousness and hunger in people suffering from mild hypoglycemia. By preventing blood sugar levels from dropping to dangerously low levels, the drug may also avert complications such as convulsions, coma, and even fatalities. Patients with insulinoma, a rare tumor of the pancreas that secretes excess insulin, can also benefit from using the medication.

Conditions Treated

  • Hypoglycemia
  • Insulinoma
  • Abnormal multiplication of pancreas islet cells

Type Of Medicine

  • Thiazide

Side Effects

Diazoxide does not necessarily produce the same side effects in all patients using it. In fact, some of the possible unfavorable outcomes of the medication do not affect specific patients at all. It is always best for an individual to check with their doctor if they experience any adverse complication they suspect results from their use of this particular hypoglycemia medication.

Though rare, an individual may treat hypoglycemia with diazoxide and experience chest pain as a result, in which case they should check with their doctor right away. Other patients using the treatment may start urinating or getting hungry or thirsty more often than usual. While still on the low blood sugar drug, it is also possible for the victim to lose weight for no apparent reason, wobble, especially when getting up from bed or a seat, or exhale fruity breath.

Not every person using diazoxide reports side effects like tiny red spots on the skin, nose bleeding, confusion, or dry mouth, but these treatment outcomes are not good at all and require immediate medical intervention. The same is true for pain in the stomach or abdomen, blurred eyesight, and dry skin.

The diazoxide side effects below warrant immediate medical attention too:

  • Pain in the stomach
  • Blood stains in urine
  • Black, tarry stools
  • Abnormally heavy menstruation
  • Abnormal fatigue or weakness
  • Unusual vulnerability to bruising/ bleeding
  • Convulsions
  • Difficulty breathing
  • Nausea/vomiting
  • Coma
  • Fever
  • Cardiac palpitations (racing heartbeat or heart beating too hard or fast)
  • Unusual sweating
  • Faintness
  • Rashes on the skin

When considering diazoxide for treating low blood sugar levels, an individual should discuss with their doctor all possible favorable and unfavorable treatment results. The caregiver helps distinguish the side effects that require medical attention from those that pose no danger to patient safety. For instance, increased body hair growth in areas like the forehead, legs, and arms is not a severe diazoxide side effect, and it usually disappears with time as the patient adjusts to the treatment.

Likewise, an individual may lose appetite or taste at some point while using diazoxide. Unless the patient is consistently unable to eat or reverse weight loss, they may not need to consult their doctor about it. However, a healthcare giver can provide practical guidelines and tips that a patient may follow to minimize the incidence or severity of any bothersome treatment outcomes.

Dosage

Diazoxide is a prescription-only drug that a patient should use strictly as their doctor directs to treat hypoglycemia. The number of daily doses, the time interval between doses, and the entire treatment period for each patient differs depending on their weight, disease, and response to medication. Only a physician may recommend an adjustment of the dosage, which is also available on the medication label. The practitioner will even consider the strength of a particular dosage form (capsule or suspension) to determine the right amount of medicine suitable for their patient.

When it comes to treating hypoglycemia in adults and children, the initial dosage is typically 3 to 8 milligrams (mg) for every kilogram (kg) that the patient weighs, split into two or three intake sessions that are eight to 12 hours apart. The dosage is subject to adjustment based on how the user responds to treatment.

Infants and newborns also require an assessment by the doctor to determine the appropriate diazoxide dosage for their low blood sugar problem. Taking into account how much the patient weighs, the healthcare professional usually gives a starting prescription of between 8 and 15 mg for each kg of baby weight, split into two or three intake sessions that are eight to 12 hours apart. Again, the doctor monitors the baby's response to treatment before recommending any dosage change.

If the doctor prescribes diazoxide in the form of capsules, the patient must not change to the suspension mode (or vice versa) on their own accord. In case of the suspension form, the medication comes with an appropriate measuring tool or spoon that the victim should use to get the prescribed dosage right each time. The traditional household spoon lacks proper calibration, so it cannot measure the dose correctly.

Along with the diazoxide dosage, a patient may also need to adopt a special diet. Any nutritional plan the doctor prescribes plays a vital role in the success of the hypoglycemia treatment, so the user should follow it strictly.

While taking diazoxide to treat hypoglycemia, the patient has to undergo regular blood sugar tests as well as urine screening for sugar and ketones. The doctor needs to see all such test results to decide how to adjust the dosing. An individual may require several dosage adjustments under the strict directives of their healthcare practitioner before finally settling for a consistent fit. If the relevant medical checkups reveal that the initial regimen is not producing the desired outcomes, the physician can suggest the necessary treatment adjustments or interventions before it is too late.

In case a patient skips their diazoxide medication, they need to take it at their earliest opportunity. Nonetheless, the timing for administering a missed dose should not be too close to the next drug intake on the patient's usual dosage schedule. Likewise, double dosing is highly discouraged.

Major drug interactions:

The effects (both pleasant and unpleasant) of a drug may change if used along with another or other medicines at the same time. Overall, adverse drug interactions can increase the occurrence or severity of side effects or cause the medication in question not work well. However, drugs do not always react adversely when used in combination, and sometimes, the benefits of treatment outweigh any likely such risks.

Prescription and over-the-counter medicines, as well as herbal healthcare remedies, present a drug interaction risk when used together with the low blood sugar drug. Those include medication for treating cold, asthma, or even appetite problems. So the patient has to err on the side of caution and inform their doctor about all such medication they are using before they can start treatment with diazoxide.

When a caregiver knows about the other drugs their patient is taking, they can provide the best care. That includes devising a strategy to prevent or control interactions by adjusting a dose or observing the patient keenly. Diazoxide bears potential reactions with medication for managing hypertension, including prazosin and enalapril. It can also interact adversely with warfarin and similar blood thinners as well as phenytoin.

If a patient seeking low blood sugar treatment is already using any of the medications below, they should let their doctor know. Similarly, any individual taking diazoxide should inform their doctor before they can start using any of the drugs on the list:

  • Aceclofenac
  • Amphetamine
  • Arsenic trioxide
  • Bromfenac
  • Choline salicylate
  • Dexketoprofen
  • Diclofenac
  • Dipyrone
  • Etodolac
  • Etoricoxib
  • Feprazone
  • Ibuprofen
  • Lisdexamfetamine
  • Meclofenamate
  • Nepafenac
  • Niflumic acid
  • Oxaprozin
  • Piketoprofen
  • Proquazone
  • Sodium salicylate
  • Valdecoxib

Taking diazoxide together with either aminolevulinic acid or trichlormethiazide at the same time can increase the possibility of side effects. That is why doctors do not usually prescribe such drugs concurrently with the hypoglycemia medicine, and when they do, it is because there is no better way around it for the patient. In such cases, health care practitioners have the option of adjusting the dosage for one or both of the medications.

When diazoxide has entered a patient's system, it may tamper with a glucagon test or other laboratory exams. If so, the checkup results may not be accurate. It makes it imperative for an individual to inform their healthcare giver or lab technicians before undergoing a medical examination while on the drug.

Of course, the doctor may liaise with a nutritionist to come up with the right diet for a patient they are treating for low blood sugar. However, a hypoglycemia victim should also be wary of foods and substances that they must avoid while taking diazoxide. It is highly advisable to compile a list of all foods, beverages, including alcohol, and chemical elements, such as tobacco the individual is currently using.

Any low blood sugar patient undergoing treatment for other complications should take the necessary precautions before starting their diazoxide regimen. They should inform their doctor about the existence of such disorders to avoid any unpleasant medication outcomes. Specifically, the medical issues below can impact the application of diazoxide:

  • Cataracts
  • Congestive heart failure
  • Fluid retention

Likewise, high bilirubin levels in the blood can impact the use of diazoxide. Also, a patient with gout or a history of gout may need close monitoring or medication/ dosage changes if they are going to use the thiazide to control hypoglycemia. Any improper use of the drug can also escalate the symptoms of pre-existing pulmonary hypertension.

It is neither safe nor proper for patients with functional hypoglycemia to use diazoxide. Additionally, caution is required when giving the medication to persons with kidney disease. The complication slows the elimination of substances from the body, meaning that diazoxide effects may increase or last longer.

Warnings

  • The symptoms of hypoglycemia should ease within 2 or 3 weeks of taking diazoxide, failure to which the patient must notify their doctor right away. It is imperative for the sick to keep seeing their doctor regularly and taking blood and urine tests, especially over the first few weeks of using the medication. It enables the physician to assess symptom improvement and determine whether or not the low blood sugar treatment is working. In turn, they may recommend any necessary adjustments to dosage/medication before it is too late.
  • Changing or stopping the diazoxide dosage without the approval of a doctor is inappropriate as it affects treatment outcomes. While taking the drug, a patient may not start, pause, or alter the dosage of any other relevant medication unless their healthcare giver recommends it.
  • Diazoxide can never be used to control low blood sugar as a result of poor eating habits or nutritional problems (functional hypoglycemia).
  • Low blood sugar symptoms can escalate and develop into a severe complication. Both conditions merit urgent medical attention.
  • If a hypoglycemia victim starts experiencing fever, they are at the risk of developing hyperglycemia or high blood sugar. In that case, they may suffer symptoms such as poor/distorted eyesight, sleepiness, rapid heartbeats, or increased thirst. The patient should take a blood sugar test and see their doctor right away.
  • Any patient using diazoxide should inform their healthcare practitioner about it before undergoing any diagnostic or treatment procedure including surgery, medical checkup, dental treatments, or emergency medicine.

Storage

  • Storage of diazoxide should be beyond the reach of minors.
  • Expired or no-longer-in-use regimens call for immediate safe disposal, if possible under the directives of a healthcare expert.
  • Lock the medication inside a prescription container at room temperature.
  • Storage for both suspension and capsule forms of the drug must avoid heat, wetness, direct light, and freezing temperatures.

Summary

Diazoxide is a thiazide medicine for treating low blood sugar levels or hypoglycemia. The drug works by preventing the body, specifically the pancreas, from discharging excess insulin that in turn obstructs the rise of glucose to healthy levels. If the excessive production of the hormone results from tumors in the pancreas, this medication may sometimes help address the resultant symptoms (not the cause). It is available in the form of capsules as well as suspension.

Adults, kids, and infants with low blood sugar can use diazoxide to treat the condition as per the directives of their doctor. Typically, the amount of medication such a patient may take in a day (twice or thrice) depends on their weight, condition, and gradual response to treatment. It is imperative for a hypoglycemia victim to get treated early and prevent the disorder from escalating to severe or even fatal levels.

There are possible drug interactions when it comes to using diazoxide. So the patient must not begin this treatment without first informing their caregiver about all other drugs they are taking. They should remember to take regular blood glucose and urine sugar/ketones tests and report the results to their doctor to help assess the effectiveness of their treatment.