diazoxide

CLINICAL USE


Treatment of hypertensive emergencies including severe hypertension associated with renal diseaseHypoglycaemia

DOSE IN NORMAL RENAL FUNCTION

Hypertension: IV: 1–3 mg/kg; maximum single dose: 150 mg, repeat after 5–15 minutesHypoglycaemia: Oral: 3–5 mg/kg in 2–3 divided doses; adjust according to response, usually 3–8 mg/kg; total doses up to 1 g have been used

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :230.7
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>90
  • %Excreted unchanged in urine &nbsp &nbsp : 50
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.2–0.3
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :20-45/30–60

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Start with a lower dose and increase gradually according to response. Use with caution

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsAntihypertensives and vasodilators: enhanced hypotensive effectMAOIs: withdraw at least 14 days before starting diazoxidePhenytoin: may reduce phenytoin levels

    ADMINISTRATION

    Reconstition

    Route

    IV bolus, oral

    Rate of Administration

    <30 seconds

    Comments

    OTHER INFORMATION

    Single doses above 300 mg have been associated with angina and myocardial and cerebral infarction. Can cause sodium and water retention