Eudaxen

Indications

Diazoxide taken by mouth is used to treat long-lasting or repeated low blood sugar (hypoglycaemia) caused by the body making too much insulin. This includes congenital hyperinsulinism in babies and children, and insulin-producing tumours of the pancreas (insulinoma) when surgery is not possible or while waiting for surgery. An injectable form was once used for severe high blood pressure but is now rarely used.

How It Works

Diazoxide opens special potassium channels (K-ATP channels) on the insulin-making beta cells of the pancreas. This keeps the cells from releasing insulin, so blood sugar rises and stays steadier. It also relaxes the muscles in blood vessel walls, which can lower blood pressure, and makes the kidneys hold on to salt and water.

Dosage and Administration

Dose as prescribed. It is worked out by the specialist according to body weight and blood sugar results, and is usually divided into 2 or 3 doses a day. Blood sugar is checked often, especially at the start and after any dose change. Shake the oral suspension well and measure with the syringe or spoon provided. Do not change or stop the dose without your doctor's advice.

Interactions

• Thiazide diuretics such as Hydrochlorothiazide or Chlorothiazide increase its blood-sugar-raising effect; doctors often give them together on purpose to reduce fluid build-up.
• Other blood pressure medicines can cause too large a fall in blood pressure.
• Insulin and diabetes tablets: their effect is opposed.
• Phenytoin: levels may fall, so seizure control may change.
• Warfarin: its effect may increase; blood tests should be checked.
• Chlorpromazine and steroids may further raise blood sugar.

Contraindications

• Allergy to Diazoxide or to thiazide diuretics (they are chemically related).
• Low blood sugar that can be managed by diet alone.
• Use with great care, only under specialist supervision, in heart failure or other conditions where fluid retention could be dangerous.

Side Effects

Common: fluid retention with swelling and weight gain, excess hair growth on the face, back and limbs (hypertrichosis), poor appetite, nausea, vomiting, fast heartbeat, low blood pressure and taste changes. Blood sugar may go too high. Less often: low white blood cell or platelet counts, raised uric acid (gout), and in newborns, high blood pressure in the lungs (pulmonary hypertension).

Get urgent medical help if there is breathlessness or fast breathing, poor feeding or blue colour in a baby, rapidly increasing swelling, signs of very high blood sugar (strong thirst, passing a lot of urine, drowsiness, deep fast breathing), unusual bleeding or bruising, fever or frequent infections, or a severe allergic reaction.

Pregnancy and Lactation

Diazoxide is generally avoided in pregnancy, especially near the end, because it can affect the baby's blood sugar, cause hair growth in the baby and slow labour. It is used only if the doctor decides it is essential. It is not known well how much passes into breast milk; ask your doctor before breastfeeding.

Precautions and Warnings

• Regular checks of blood sugar, blood pressure, weight, blood counts and uric acid are needed.
• Babies and young children need close watching for fluid build-up and breathing problems.
• People with kidney disease may need a lower dose.
• Tell your doctor if you have heart disease, gout or liver disease.
• Continue regular meals as advised; Diazoxide does not replace dietary care.

Overdose

Too much can cause very high blood sugar, which can lead to ketoacidosis (a dangerous build-up of acids in the blood), and low blood pressure. This is an emergency: go to hospital at once. Treatment may include insulin, fluids and close monitoring for several days because the effect lasts a long time.

Therapeutic Class

Antihypoglycaemic agent (potassium channel opener, benzothiadiazine derivative).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep the oral suspension tightly closed and follow the label for how long it can be used after opening.