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Should you use a diuretic with diazoxide?

Medically reviewed by Melisa Puckey, BPharm. Last updated on July 2, 2020.

Do you need diuretic with diazoxide? What do you administer with diazoxide?

Official Answer

by Drugs.com

Should you use a diuretic with diazoxide?

A diuretic may be required in some people who are on oral diazoxide, if they have developed the diazoxide side effects of fluid retention, edema or congestive heart failure.

Diazoxide and fluid retention

Fluid retention is a clinically important and significant side effect of diazoxide.

  • Diazoxide causes an unwanted increase in water and sodium retention which means the body accumulates extra fluid.
  • The fluid retained in the body can lead to swelling and puffiness of lower arms and legs (edema) and can lead to congestive heart failure if not managed properly.
  • Fluid retention may be treated with thiazide diuretics including chlorothiazide and hydrochlorothiazide.
  • The addition of a thiazide diuretic may make the diazoxide more effective at increasing the blood sugar, so the diazoxide dose may need adjusting if you start taking a thiazide diuretic.

While on diazoxide, symptoms and signs of fluid retention need to be regularly evaluated.

Due to this fluid retention side effect diazoxide should be used cautiously in patients with congestive heart failure or poor cardiac function, and these patients intensive monitoring.

For more information on other diazoxide side effects click here: diazoxide side effects

What is oral diazoxide (Proglycem) used for?

Oral diazoxide (Proglycem) is used to increase blood sugar levels in patients that have low blood sugar that has been caused by specific medical conditions that increase the amount of insulin in the bloodstream.

The medical conditions in adults that cause this increase in insulin are

  • inoperable islet cell adenoma or carcinoma
  • extrapancreatic malignancy

In infants and children the conditions are

  • leucine sensitivity
  • islet cell hyperplasia
  • nesidioblastosis
  • extrapancreatic malignancy
  • islet cell adenoma
  • adenomatosis

Oral diazoxide (Proglycem) is NOT used to treat occasional low blood sugar caused by diet.

How does oral diazoxide work?

The insulin in our body reduces the blood sugar levels, so in conditions that have an excess in insulin levels this causes low blood glucose levels. The oral diazoxide works by reducing the amount of insulin that is released from the pancreas, so there is less insulin in the bloodstream, which means that the blood sugar levels will increase to a more normal level.

Bottom line:

  • Oral diazoxide is used to treat low blood glucose (hypoglycemia) caused by medical conditions that have too much insulin (hyperinsulinemia)
  • One of the side effects diazoxide can cause is fluid retention, swollen and puffs lower arms and leg (edema) and congestive heart failure
  • Fluid retention caused by diazoxide may be treated with diuretics, if you develop this side effect.
References

Diazoxide Medication information https://www.drugs.com/mtm/diazoxide.html

Long-term medical treatment in congenital hyperinsulinism https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660626/

Congenital Hyperinsulinism https://emedicine.medscape.com/article/923538

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