By Rania Gollakner, BS, DVM, MPH

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’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions 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 visibly obvious and therefore laboratory tests may need to be done to evaluate how well this medication is working.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

The most common side effects include drooling, lack of appetite, vomiting, and diarrhea. Serious side effects include a fast heartbeat, fever, bleeding, bruising, drinking and urinating more, prolonged lack of appetite, muscle weakness, severe vomiting, muscle twitches, seizures, or collapse. In ferrets, side effects include lack of appetite, vomiting, diarrhea, tiredness, and bone marrow abnormalities.

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?

Diazoxide should not be used in pets that are allergic to it or thiazide diuretics. Do not use in pets with low blood sugar due to anything other than a tumor. Diazoxide should be used cautiously in pets with heart or kidney disease and very cautiously in pregnant or nursing pets as safety has not been established.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with diazoxide: alpha-adrenergic agents, glucocorticoids, hypotensive agents, phenothiazines, phenytoin, or thiazide diuretics.

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

Is there any monitoring that needs to be done with this medication?

Blood sugar levels, blood cell counts, and physical examinations should be performed at regular intervals. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor your pet at home for serious side effects.

How do I store diazoxide?

Store the capsules and liquid suspensions between 2°C and 30°C (36°F and 86°F) and 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.

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