Diazoxide: veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

Proglycem, Eudemine

Species with doses

Dogs, Cats and Ferrets

General dose range

5–30 mg/kg PO q12h (divided) — check the species tables for the indication

Routes

PO

Last reviewed

1 October 2026

Indications

• Insulinoma — control of refractory/recurrent hypoglycaemia (medical management)
• Other hyperinsulinaemic hypoglycaemic states (rare)
• Adjunct when surgery is not curative or is declined

Diazoxide dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Insulinoma — hypoglycaemia control: Plumb’s p.384: start 5 mg/kg PO q12h, increasing to a maximum of 30 mg/kg PO q12h to control signs (Meleo & Caplan); or 10 mg/kg/day divided q12h, rising to 60 mg/kg/day as tolerated, ± hydrochlorothiazide 2–4 mg/kg/day (Feldman & Nelson). Extra-pancreatic insulin-secreting tumours: 5–13 mg/kg PO q8h. Give with food; combine with frequent small meals ± prednisolone. Not in Papich 5e.

Cats

• Insulinoma (uncommon): Plumb’s p.384 (Meleo & Caplan 2000): start 5 mg/kg PO q12h, increasing to a maximum of 30 mg/kg PO q12h to control signs. Rare in cats.

Ferrets

• Insulinoma hypoglycaemia (post-op, refractory to prednisone): Plumb’s p.384 (Johnson 2006): add when prednisone (0.5–2 mg/kg PO q12h) alone fails; begin 5–10 mg/kg PO q12h and lower the prednisone at the same time. Carpenter’s ferret table: 5–30 mg/kg PO q12h. May cause hypertension, lethargy and nausea.

Contraindications

Diabetes mellitus / hyperglycaemic states. Significant cardiac disease or fluid retention (it causes sodium/water retention). Hypersensitivity to thiazide-related compounds. Pregnancy. Known hypersensitivity. Confirm insulinoma diagnosis.

Species-specific warnings

Dogs: For insulinoma management, balance the dose against blood glucose — too much causes hyperglycaemia/fluid retention; pair with diet and adjuncts (prednisolone/octreotide).

Adverse effects

• Sodium/water retention, oedema (thiazide-related)
• Vomiting, anorexia (give with food)
• Hyperglycaemia (intended, but can overshoot)
• Tachycardia; bone-marrow effects and hypertrichosis with chronic use
• Cataracts, pancreatitis (reported)

Drug interactions

• Thiazide diuretics: enhance the hyperglycaemic and hyperuricaemic effects (sometimes used to counter fluid retention)
• Insulin/oral hypoglycaemics: opposing effects
• Phenytoin: levels reduced; protein-binding interactions
• Antihypertensives: additive hypotension (in the antihypertensive context)

Pregnancy and lactation

Avoid in pregnancy (hyperglycaemia/fluid effects; limited safety data).

Monitoring

• Blood glucose (the efficacy/safety marker) — titrate to control hypoglycaemic signs without marked hyperglycaemia
• Body weight / oedema (sodium-water retention)
• Electrolytes, CBC on chronic use
• Clinical control of insulinoma signs (collapse/seizures)

Toxicity and overdose

Overdose causes marked HYPERGLYCAEMIA (potentially ketoacidosis/hyperosmolar state), sodium/water retention with oedema, hypotension and tachycardia. Chronic use can cause hypertrichosis, cataracts, and haematologic effects. Effects relate to its pharmacology rather than narrow organ toxicity.

Management: No specific antidote. For severe hyperglycaemia, manage with fluids and insulin as needed (carefully — the underlying disease is hypoglycaemia); treat fluid retention and support blood pressure. Monitor glucose and electrolytes closely. Discontinue/reduce dose.

Clinical pearls

• The drug that "turns insulin off" — used to control refractory insulinoma hypoglycaemia when surgery isn't curative; it is the opposite problem to diabetes
• Titrate to blood glucose; combine with frequent small carbohydrate-rich meals and often prednisolone ± octreotide
• Watch for fluid retention/oedema (thiazide-related) and overshoot into hyperglycaemia
• Variable efficacy and cost limit it — but it can meaningfully extend good-quality life in insulinoma dogs

Mechanism of action

Opens ATP-sensitive potassium channels on pancreatic beta-cells, hyperpolarising the cell and preventing the calcium influx needed to trigger insulin secretion — so it directly INHIBITS insulin release and raises blood glucose. It also has extrapancreatic effects (reduced peripheral glucose uptake, catecholamine-mediated glycogenolysis) and, via the same K-channel action on vascular smooth muscle, causes vasodilation/sodium retention (its human antihypertensive effect).

Formulations and products

• Capsule 50 mg (Proglycem)
• Oral suspension 50 mg/mL
• Proglycem — 50 mg capsule; 50 mg/mL suspension, Capsule / suspension (human-label)

Storage

Capsules/suspension: 15–30 °C, protect from light; shake suspension.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other hormones, emergency drugs, supplements and other drugs

• Deferoxamine (Desferrioxamine)
• Deslorelin
• Desmopressin (DDAVP)
• Desoxycorticosterone Pivalate (DOCP)
• Dimercaprol (BAL)
• Dinoprost (PGF2α)
• Diphenhydramine
• Doxapram

Frequently asked questions