Antihypoglycaemic (KATP channel opener) Pregnancy: Eudemine tablets are only to be used in pregnant women when the indicated condition is deemed to put the mother's life at risk. Prolonged oral therapy during pregnancy has been reported to cause alopecia in the newborn. Should not be given to nursing mothers as safety during lactation has not been established.

Diazoxide

Brand names: Eudemine, Proglycem

Diazoxide is used to control persistent hypoglycaemia caused by excess insulin secretion, including hyperinsulinism and insulin-secreting tumours.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Hypoglycaemia: starting oral dose 5 mg/kg body weight divided into 2 or 3 equal doses per 24 hours; usual maintenance dose 3-8 mg/kg/day in two or three divided doses

Route: Oral

Frequency: In 2 or 3 divided doses per 24 hours

Max: Up to 1,000 mg per day in adults with insulin-producing islet-cell tumours

Dosage in hypoglycaemia is determined by clinical need and individual response. The 5 mg/kg starting dose (for both adults and children) establishes the patient's response, after which the dose can be increased until symptoms and blood glucose respond satisfactorily. Regular blood glucose determinations in the initial days of treatment are essential. In adults with benign or malignant islet-cell tumours producing large quantities of insulin, high dosages of up to 1,000 mg per day have been used. Blood pressure must be monitored regularly; sodium/water retention likely necessitates an oral diuretic. Reduced doses may be required in impaired renal function. (Note: US openFDA label describes VYKAT XR, a diazoxide choline extended-release product for Prader-Willi hyperphagia, a different indication/formulation — not used for this dose.)

Paediatric dose

Dose: 5 mg/kg

Route: Oral

Frequency: Divided into 2 or 3 equal doses per 24 hours (starting dose)

Max: Not stated for children; leucine-sensitive hypoglycaemia 15-20 mg/kg/day suggested

Hypoglycaemia starting oral dose is 5 mg/kg/day for both adults and children; usual maintenance 3-8 mg/kg/day in two or three divided doses. In children with leucine-sensitive hypoglycaemia a dosage range of 15-20 mg/kg/day is suggested. Necrotising enterocolitis (including fatal) reported in neonates; monitor for vomiting, abdominal distension, bloody stools, lethargy. Pericardial effusion reported mostly in paediatric patients including infants. Regular assessment of growth, bone and psychological maturation required. Clinician to verify against a children's formulary.

Dose adjustments

Renal

Reduced doses may be required in patients with impaired renal function. In severe renal failure, maintain urinary volumes in excess of 1 litre daily with diuretic therapy.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Paediatric weight-based calculator

Patient weight (kg)

Verify in a children's formulary

Contraindications

Hypersensitivity to the active substance, other thiazides, or any excipient
In the treatment of hypoglycaemia, all cases which are amenable to surgery or other specific therapy

Side effects

Nausea (common in first two or three weeks)
Hypertrichosis lanuginosa, anorexia and hyperuricaemia (after prolonged therapy)
Extra-pyramidal effects (parkinsonian tremor, cogwheel rigidity, oculogyric crisis)
Sodium and water/fluid retention; inappropriate hyperglycaemia including ketoacidosis; hyperosmolar non-ketotic coma
Cardiomegaly, cardiac failure, arrhythmias, pericardial effusion; necrotising enterocolitis (neonatal, not known frequency)

Interactions

Diuretics e.g. frusemide, ethacrynic acid (potentiate both hypotensive and hyperglycaemic activity of diazoxide; diazoxide dose likely requires downward adjustment)

Clinical monograph

How it works

It opens ATP-sensitive potassium channels on pancreatic beta cells, hyperpolarising them and inhibiting insulin release, thereby raising blood glucose.

Prescribing in practice

It causes sodium and fluid retention, so a diuretic is often co-prescribed and it must be used cautiously in cardiac or renal impairment, with vigilance for heart failure.
The MHRA has warned of a risk of pulmonary hypertension, particularly in neonates and infants, requiring monitoring and discontinuation if it develops.
Hypertrichosis is a common effect with prolonged use and blood counts can be affected.

Monitoring

Monitor blood glucose, fluid balance and weight, blood pressure and full blood count, with assessment for pulmonary hypertension in infants.

Counselling the patient

Increased hair growth may occur and is usually reversible after stopping.
Report breathlessness, swelling or rapid weight gain promptly.
Do not stop treatment suddenly without medical advice.

Evidence & guidelines

An MHRA Drug Safety Update highlighted the risk of pulmonary hypertension with diazoxide, particularly in neonates and infants.

Reference: SmPC Eudemine; FDA Drug Safety Communication July 2015 (pulmonary HTN); BSPED Hyperinsulinism Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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