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PloS One 2021Diazoxide is the first-line drug for treating hyperinsulinism and the only pharmacological agent approved for hyperinsulinism by the Federal Drug Administration. This... (Meta-Analysis)
Meta-Analysis
Diazoxide is the first-line drug for treating hyperinsulinism and the only pharmacological agent approved for hyperinsulinism by the Federal Drug Administration. This systemic review and meta-analysis aimed to investigate the efficacy and safety of diazoxide for treating hyperinsulinemic hypoglycemia (HH). The meta-analysis of the efficacy and safety of diazoxide in treating HH was performed by searching relevant studies in the PubMed, Embase, and Cochrane databases. The findings were summarized, and the pooled effect size and its 95% confidence interval (CI) were calculated. A total of 6 cohort studies, involving 1142 participants, met the inclusion criteria. Among the cohort studies, the pooled estimate of the response rate of diazoxide therapy was 71% (95% CI 50%-93%, Pheterogeneity< 0.001, I2 = 98.3%, Peffect< 0.001). The common side effects were hypertrichosis (45%), fluid retention (20%), gastrointestinal reaction (13%), edema (11%), and neutropenia (9%). Other adverse events included pulmonary hypertension (2%) and thrombocytopenia (2%). This meta-analysis suggested that diazoxide was potentially useful in HH management; however, it had some side effects, which needed careful monitoring. Furthermore, well-designed large-scale studies, such as randomized controlled trials, might be necessary in the future to obtain more evidence.
Topics: Antihypertensive Agents; Diazoxide; Humans; Hyperinsulinism; Hypertrichosis; Hypoglycemia; Treatment Outcome; Vasodilator Agents
PubMed: 33571197
DOI: 10.1371/journal.pone.0246463 -
The Medical Letter on Drugs and... Jun 1973
Topics: Blood Pressure; Diazoxide; Ethacrynic Acid; Female; Furosemide; Humans; Hypertension; Hypertension, Malignant; Infant, Newborn; Pregnancy
PubMed: 4736480
DOI: No ID Found -
Journal of Perinatology : Official... Nov 2018Diazoxide is used to treat infants with persistent hypoglycemia, but the prevalence of its use and adverse effects are not well described. We report demographic and...
OBJECTIVE
Diazoxide is used to treat infants with persistent hypoglycemia, but the prevalence of its use and adverse effects are not well described. We report demographic and clinical characteristics of infants treated with diazoxide in neonatal intensive care units (NICUs).
STUDY DESIGN
Retrospective cohort study of infants 24-41 weeks' gestation admitted to 392 NICUs from 1997-2016, comparing characteristics between hypoglycemic infants exposed/not exposed to diazoxide. For diazoxide courses > 1 day, we report percentages of infants starting diuretics and/or developing new ventilator/oxygen requirement during therapy.
RESULTS
Among 1,249,466 infants, 185,832 had hypoglycemia; 1066/185,832 (0.57%) received diazoxide. Diazoxide use increased over time (P = 0.001). Infants receiving diazoxide varied from 0-14.9% among centers. New diuretic courses were associated with 91/664 (14%), and new oxygen or ventilator requirement during therapy was associated with 64/556 (12%) and 34/647 (5%), respectively.
CONCLUSIONS
Diazoxide use in NICU settings has increased over time. Infants receiving diazoxide commonly received diuretics.
Topics: Diazoxide; Drug Utilization; Female; Gestational Age; Humans; Hypoglycemia; Infant, Newborn; Intensive Care Units, Neonatal; Male; Prevalence; Retrospective Studies; United States
PubMed: 30206345
DOI: 10.1038/s41372-018-0218-4 -
Internal Medicine (Tokyo, Japan) 2014A 24-year-old healthy woman presented at our hospital due to hypoglycemia. A fasting test provoked spontaneous hypoglycemia, and contrast-enhanced abdominal computed...
A 24-year-old healthy woman presented at our hospital due to hypoglycemia. A fasting test provoked spontaneous hypoglycemia, and contrast-enhanced abdominal computed tomography revealed a pancreatic tumor. We diagnosed her with insulinoma and initiated diazoxide treatment to prevent hypoglycemia. After 13 days of treatment, she experienced nasal bleeding, and her platelet count decreased from 186,000 /μL to 28,000 /μL. The thrombocytopenia was ameliorated five days after diazoxide was discontinued. Although diazoxide has hyperglycemic effects associated with decreased insulin secretion, diazoxide-induced thrombocytopenia is rare. A complete blood count should be obtained periodically in patients receiving treatment with diazoxide.
Topics: Biopsy; Diagnosis, Differential; Diazoxide; Female; Humans; Insulinoma; Pancreatic Neoplasms; Thrombocytopenia; Tomography, X-Ray Computed; Vasodilator Agents; Young Adult
PubMed: 24694492
DOI: 10.2169/internalmedicine.53.1094 -
Hypertension (Dallas, Tex. : 1979) 1982The pharmacokinetic disposition and antihypertensive response of bolus infusions of diazoxide, 1, 2, or 4 mg/kg over 5, 10, or 20 seconds, were examined in seven...
The pharmacokinetic disposition and antihypertensive response of bolus infusions of diazoxide, 1, 2, or 4 mg/kg over 5, 10, or 20 seconds, were examined in seven patients with chronic stable essential hypertension and mean arterial pressures (MAP) between 122 and 155 mm Hg off therapy. Maximal reductions in MAP were noted 2 minutes after each dose, and a linear correlation was obtained in all patients between dose or plasma diazoxide concentration and maximal change in MAP. Individual concentration-time curves were analyzed to determine the apparent volume of distribution at steady state (Vdss range, 0.178 to 0.250 liter/kg), beta t 1/2 (range, 32 to 62.5 hours), and plasma clearance rate (Clp range, 2.2 to 5.3 ml/kg . hour-1) for the calculation of loading and maintenance doses designed to produce steady-state concentrations within 0.5 hours. These infusions resulted in steady-state reductions in MAP (16% to 30%) which could be predicted from the concentration-response curves of each patient after bolus infusions. With the use of kinetic principles, a diazoxide dose regimen (average load, 7.5 mg/kg at 7.5 mg/min; average maintenance, 10% of loading dose every 6 hours) produced gradual and predictable reductions in MAP in patients with accelerated hypertension, since the response was proportional to plasma diazoxide concentrations.
Topics: Adolescent; Adult; Aged; Diazoxide; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Hypertension; Kinetics; Male; Middle Aged; Regression Analysis; Time Factors
PubMed: 7061124
DOI: 10.1161/01.hyp.4.1.167 -
Archives of Disease in Childhood Sep 2023
Topics: Female; Infant, Newborn; Humans; Diazoxide; Enterocolitis, Necrotizing; Hypoglycemia; Infant, Newborn, Diseases; Fetal Diseases
PubMed: 37369382
DOI: 10.1136/archdischild-2023-325726 -
BMJ (Clinical Research Ed.) Feb 1992
Topics: Diazoxide; Drug Industry; Humans
PubMed: 1739847
DOI: 10.1136/bmj.304.6822.320-b -
Lancet (London, England) Feb 1977
Topics: Blood Glucose; Diabetes Mellitus; Diazoxide; Drug Antagonism; Glipizide; Humans; Hypoglycemia; Insulin; Insulin Secretion; Male; Middle Aged; Sulfonylurea Compounds
PubMed: 64831
DOI: 10.1016/s0140-6736(77)91853-0 -
PloS One 2016The objective of this study was to evaluate the stability of diazoxide in extemporaneously compounded oral suspensions. Oral suspensions of diazoxide 10 mg/mL were...
The objective of this study was to evaluate the stability of diazoxide in extemporaneously compounded oral suspensions. Oral suspensions of diazoxide 10 mg/mL were prepared from either bulk drug or capsules dispersed in either Oral Mix or Oral Mix Sugar Free. These suspensions were stored at 5°C and 25°C/60%RH in bottles and oral syringes for a total of 90 days. At predetermined time intervals, suspensions were inspected for homogeneity, color or odor change; the pH was measured and the concentration of diazoxide was evaluated by ultraviolet detection using a stability-indicating high pressure liquid chromatography method. All preparations were demonstrated to be chemically stable for at least 90 days.
Topics: Capsules; Chromatography, High Pressure Liquid; Diazoxide; Drug Compounding; Drug Stability; Drug Storage; Hydrogen-Ion Concentration; Spectrophotometry, Ultraviolet; Temperature
PubMed: 27727306
DOI: 10.1371/journal.pone.0164577 -
Annals of Internal Medicine Oct 1976
Topics: Angina Pectoris; Blood Pressure; Coronary Disease; Diazoxide; Dose-Response Relationship, Drug; Drug Therapy, Combination; Furosemide; Humans; Hypertension; Male; Middle Aged; Myocardial Infarction
PubMed: 970782
DOI: 10.7326/0003-4819-85-4-529