Diazoxide

What is diazoxide?

Diazoxide (brand names: Proglycem®, Eudemine®, Glicemin®, Hypertonalum®, Proglicem®, Sefulken®, Tensuril®) is a medication used to treat low blood sugar in pets with an insulinoma (a tumor of insulin-producing cells in the pancreas).

Its use in cats, dogs, ferrets, and other small mammals to treat low blood sugar due to an insulinoma is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. 

“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is diazoxide given?

• Diazoxide is given by mouth in the form of a liquid suspension or compounded capsule.
• Give with food.
• Shake liquids well before dosing.
• Measure liquid forms carefully.

This medication should take effect within 1 to 2 hours; however, effects may not be noted outwardly, so laboratory tests may be needed to evaluate this medication’s effectiveness.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

Diazoxide may cause the following side effects:

• Drooling
• Lack of appetite
• Vomiting
• Diarrhea

In ferrets, diazoxide may cause the following side effects:

• Lack of appetite
• Vomiting
• Diarrhea
• Tiredness
• Bone marrow abnormalities

Serious adverse reactions may occur. If any of the following signs develop, stop giving diazoxide and contact your veterinarian immediately:

• Fast heartbeat
• Fever
• Bleeding
• Bruising
• Drinking and urinating more
• Prolonged lack of appetite
• Muscle weakness
• Severe vomiting
• Muscle twitches
• Seizures
• Collapse

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE diazoxide in:

• Pets that are allergic to it or thiazide diuretics
• Pets with low blood sugar due to anything other than a tumor

USE WITH CAUTION in:

• Pets with heart or kidney disease
• Pets that are pregnant or nursing (safety has not been established)

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with diazoxide, including:

• Glucocorticoids
• Hypotensive agents
• Phenothiazines
• Thiazide diuretics

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Your veterinarian will perform a physical examination and test blood sugar levels and blood cell counts at regular intervals.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store diazoxide?

• Store capsules and liquid suspensions between 36°F and 86°F (2°C and 30°C).
• Protect from light and freezing.
• Do not use liquid suspensions that have darkened in color, as this may indicate that the medication is no longer effective.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.