Neonatal Drug Therapy Manual

Diazoxide

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated March 5, 2024 - 2:39pm

Alternate Name(s): 
Proglycem
Classification: 
Antihypoglycemic, Antihypertensive
Original Date: 
March 2021
Revised Date: 
March 2022
Indications: 
  • Management of hypoglycemia related to hyperinsulinism
Administration: 
  • PO
Dosage: 
  • Initial 10 mg/kg/day divided every 8 to 12 hours; usual range: 5 - 15 mg/kg/day divided every 8 to 12 hours
    • Lower initial doses (5 - 7.5 mg/kg/day) should be used for patients with congenital heart disease
  • Concurrent addition of Hydrochlorothiazide with the initiation of Diazoxide can be considered to minimize risk of fluid retention.  Hydrochlorothiazide should be started at 1 mg/kg/day divided daily or bid  
Side Effects: 
  • CVS: edema (due to antidiuretic effect which leads to a decrease in sodium and water excretion), pulmonary hypertension*
    • There have been postmarketing reports of pulmonary hypertension occuring in neonates and infants treated with diazoxide .  Risk is higher if infant has pre existing risk factors for pulmonary hypertension. The cases were reversible upon discontinuation of the drug. Monitor patients at risk for respiratory distress and discontinue diazoxide if pulmonary hypertension is suspected.
  • Endocrine and metabolic: hypertrichosis, hyperuricemia, sodium and water retention
  • Hematologic: neutropenia, thrombocytopenia
  • Hepatic: elevated liver enzymes
  • Renal: decreased creatinine clearance, decreased urinary output
Parameters to Monitor: 
  • Blood glucose
  • CBC with differential, platelets
  • Serum uric acid level
  • Electrolytes
  • BUN and serum creatinine
  • Liver function tests
  • BP/HR
Reconstitution and Stability: 

N/A

Compatibility: 

N/A

References: 

- Herrera A, Vajravelu ME, Givler S, Mitteer L, Avitabile CM, Lord K, De Leon, DD.  Prevalence of Adverse Events in Children with Congenital Hyperinsulinism Treated with Diazoxide.  J Clin Endocrinol Metab 2018; 103: 4365-4372

- Gray KD, Dudash K, Escobar C, Freel C, Harrison T, McMillan C et al. Prevalence and Safety of Diazoxide in the Neonatal Intensive Care Unit.  J Perinatol 2018; 38 (11): 1496-1502

- Welters A, Lerch C, Kummer S, et al. Long-term medical treatment in congenital hyperinsulinism: a descriptive analysis in a large cohort of patients from different clinical centers. Orphanet J Rare Dis. 2015;10:150. Published 2015 Nov 25. doi:10.1186/s13023-015-0367-x

- Taketomo CK, Hodding JH, Kraus DM. Pediatric & Neonatal Dosage Handbook 22nd Edition. Hudson: Lexi-Comp Inc.; 2015

- Desai J, Key L, Swindall A, Gaston K, Talati AJ. The danger of diazoxide in the neonatal intensive care unit. Ther Adv Drug Saf. 2021 May 18;12:20420986211011338 *

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.