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 :230.7

%Protein binding :>90

%Excreted unchanged in urine : 50

Volume of distribution (L/kg) :0.2–0.3

half-life – normal/ESRD (hrs) :20-45/30–60

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Start with a lower dose and increase gradually according to response. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

HD :Dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :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

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Route

IV bolus, oral

Rate of Administration

<30 seconds

Comments

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OTHER INFORMATION

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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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