<p>In the treatment of hypoglycaemia it is necessary that the blood pressure be monitored regularly. Retention of sodium and water is likely to necessitate therapy with an oral diuretic such as frusemide or ethacrynic acid The dosage of either of the diuretics mentioned may be up to 1g daily. It must be appreciated that if diuretics are employed then both the hypotensive and hyperglycaemic activities of Diazoxide will be potentiated and it is likely that the dosage of Diazoxide will require adjustment downwards. In patients with severe renal failure it is desirable to maintain, with diuretic therapy, urinary volumes in excess of 1 litre daily. Hypokalaemia should be avoided by adequate potassium replacement.<br />
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Diazoxide should be used with caution in patients with cardiac failure or impaired cardiac reserve in whom sodium and water retention may worsen or precipitate congestive heart failure. A direct effect on myocardium and cardiac function cannot be excluded.<br />
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Diazoxide should be used with care in patients with impaired cardiac or cerebral circulation and in patients with aortic coarctation, aortic stenosis, arteriovenous shunt, heart failure or other cardiovascular disorders in which an increase in cardiac output could be detrimental.<br />
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Diazoxide should be administered with caution to patients with hyperuricaemia or a history of gout, and it is advisable to monitor serum uric acid concentration.<br />
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Whenever Diazoxide is given over a prolonged period regular haematological examinations are indicated to exclude changes in white blood cell and platelet counts.<br />
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Also in children there should be regular assessment of growth, bone and psychological maturation.<br />
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The very rapid, almost complete protein binding of Diazoxide requires cautious dosage to be used in patients whose plasma proteins may be lower than normal</p>