Proglycem (Diazoxide) - Oral

What Is Proglycem?

Proglycem (diazoxide) is an oral prescription drug used to treat hypoglycemia (low blood sugar) due to hyperinsulinism (making too much insulin, which lowers blood sugar) caused by certain conditions.

Proglycem works by preventing the pancreas from releasing insulin. This helps increase glucose (sugar) levels.

It is available as an oral suspension (liquid). It comes with a calibrated dropper that delivers doses in 10-milligram increments.

Drug Facts

Generic Name: Diazoxide

Brand Name(s): Proglycem

Drug Availability: Prescription

Therapeutic Classification: Anti-hypoglycemic

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Diazoxide

Dosage Form(s): Suspension

What Is Proglycem Used For?

The Food and Drug Administration (FDA) approved Proglycem to manage hypoglycemia (low blood sugar) caused by hyperinsulinism from certain conditions, such as a tumor on the pancreas, cancer, or a condition called leucine sensitivity.

With leucine sensitivity, certain foods high in an amino acid called leucine (such as salmon, eggs, and brown rice) can cause low blood sugar. These conditions cause the release of too much insulin, which lowers blood sugar. Proglycem prevents the pancreas from releasing too much insulin, which helps keep blood sugar levels stable.

Proglycem can be used in adults, children, and infants.

How to Take Proglycem

If prescribed Proglycem, read the prescription label and the information leaflet with your medication. Consult your healthcare provider if you have any questions.

Use Proglycem precisely as directed by your provider. Do not take more or less than prescribed.

Shake the bottle well before you measure a dose. Measure the liquid with a dosing syringe or medicine measuring cup. Do not use kitchen utensils to measure medicine. Ask your pharmacist if you need help finding a measuring device.

Take Proglycem at the same time intervals every day. For example, if your prescription is for twice a day, you can take Proglycem 12 hours apart at 9 a.m. and 9 p.m. If your prescription is for three times daily, you will take Proglycem eight hours apart. For example, take it at 8 a.m., 4 p.m., and 12 a.m.

Follow your healthcare provider's instructions for checking blood sugar and ketones, and ask what results are normal and when you should contact their office. You should also ask for advice on how to adjust your diet.

If your condition does not improve after two weeks, consult your healthcare provider.

Storage

Store at room temperature (between 68 F and 77 F), away from heat, direct light, and moisture. Keep this medication in its original labeled container and out of reach of children and pets. Keep the bottle tightly closed when not in use.

How Long Does Proglycem Take to Work?

Proglycem starts to work within one hour, lasting up to eight hours.

What Are the Side Effects of Proglycem?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, Proglycem can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

The most common side effects of Proglycem are:

  • Excessive hair growth on the body (hypertrichosis)
  • Fluid and salt retention
  • Appetite loss
  • Gastrointestinal (GI) side effects, such as nausea, vomiting, abdominal pain, and diarrhea
  • Ileus (a condition where the movement of the intestines is interrupted)
  • Neutropenia (low levels of neutrophils, a type of white blood cell)
  • Temporary loss of taste
  • Decreased levels of hemoglobin and hematocrit (measurement of red blood cells)
  • Fast heart rate and heart palpitations
  • Headache
  • Hyperglycemia (high blood sugar)
  • Low blood pressure
  • Low platelet levels, which can increase the risk of bleeding
  • Rash
  • Loss of scalp hair
  • Weakness, feeling unwell

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Acute pancreatitis: Symptoms may include abdominal pain, nausea, and vomiting.
  • Diabetic ketoacidosis (DKA): DKA is a life-threatening medical emergency and requires immediate medical attention in the hospital. DKA occurs when there is a build-up of ketones, or acids, in the blood. Symptoms may include thirst, frequent urination, nausea, stomach pain, weakness, fruity breath odor, and confusion.
  • Heart failure: Symptoms may include shortness of breath, rapid weight gain, and swelling.
  • High blood sugar: Symptoms can include increased thirst and urination, hunger, weight loss, dry mouth, fruity breath odor, drowsiness, dry skin, and blurred vision.
  • Hyperosmolar nonketotic coma: Very high blood sugar with severe dehydration and altered mental status or coma. This requires emergency medical treatment.
  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing.
  • Low platelet levels: This can be seen on blood tests, and symptoms can include easy bruising and bleeding.
  • Pancreatic necrosis: Symptoms include stomach pain, fever, swelling in the belly area, nausea, and vomiting. This requires emergency medical attention.
  • Pulmonary hypertension (high blood pressure in the lungs) in children under two years old: Symptoms can include shortness of breath and dizziness.

Long-Term Side Effects

While many people tolerate Proglycem well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

Moderate long-term side effects can include:

  • Blood in the urine
  • Cataracts (clouding of the eye lens) and other vision problems
  • Constipation
  • Gout (a type of arthritis that often affects the big toe)
  • High blood sugar
  • Increased liver enzymes
  • Low platelet levels
  • Low red and white blood cells
  • Milky nipple discharge (even if you are not breastfeeding)
  • Orthostatic hypotension (a drop in blood pressure when standing up that causes dizziness)
  • Swelling; fluid and salt retention

Severe long-term side effects may include:

  • Bleeding inside the eye
  • DKA
  • Hearing loss
  • Heart failure (the heart does not pump blood as well as it should)
  • Ileus
  • Muscle paralysis (loss of muscle function in part of the body)
  • Pancreas problems
  • Pulmonary hypertension
  • Seizures

Report Side Effects

Proglycem may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Proglycem Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or suspension):
    • For low blood sugar:
      • Adults and children—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 3 to 8 milligram (mg) per kilogram (kg) of body weight, divided into two or three doses, taken every 8 to 12 hours. Your doctor may increase your dose as needed and tolerated.
      • Newborn babies and infants—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 8 to 15 mg per kg of body weight, divided into two or three doses, taken every 8 to 12 hours. Your doctor may increase your dose as needed and tolerated.

Modifications

You may need to use a lower dose or avoid Proglycem if you have kidney problems. Talk to your healthcare provider about potential modifications.

Proglycem should not be used during pregnancy because it can cause harm to the fetus. It is also not recommended to breastfeed while taking it.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next scheduled dose. Do not take two doses to make up for a missed dose.

Overdose: What Happens If I Take Too Much Proglycem?

Taking too much Proglycem can cause severely high blood sugar and DKA. Treatment in the hospital is needed and will consist of insulin, fluids, electrolytes, and close monitoring for up to seven days.

Always take the prescribed amount of your medication. If you accidentally take too much, contact your healthcare provider or the Poison Control Center. Get immediate medical help or call 911 if you develop overdose symptoms that are severe or life-threatening.

What Happens If I Overdose on Proglycem?

If you think you or someone else may have overdosed on Proglycem, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Proglycem, call 911 immediately.

Precautions

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It is very important that your doctor check your or your child's progress at regular visits, especially during the first few weeks of treatment, to make sure that this medicine is working properly. Blood and urine tests will be needed to check for unwanted effects.

Before you have any kind of medical tests, surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine.

Hyperglycemia (high blood sugar) may occur if you have a fever or infection. Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed and dry skin, a fruit-like breath odor, increased frequency and amount of urination, ketones in the urine, loss of appetite, nausea or vomiting, rapid and deep breathing, tiredness, or unusual thirst. If symptoms of high blood sugar occur, check your blood sugar level and call your doctor for instructions.

Symptoms of both low blood sugar and high blood sugar must be corrected before they progress to a more serious condition. In either situation, check with your doctor immediately.

Do not take any other medicine, unless prescribed or approved by your doctor, since some may interfere with this medicine's effects. This especially includes over-the-counter (OTC) or nonprescription medicine such as that for colds, cough, asthma, hay fever, or appetite control.

What Are Reasons I Shouldn't Take Proglycem?

Proglycem is not appropriate for everyone. Do not take this medication if you:

  • Are allergic to diazoxide or any of the inactive ingredients in Proglycem
  • Are allergic to sulfa drugs or thiazides (a type of diuretic or "water pill")
  • Are pregnant, unless approved by your healthcare provider
  • Have functional hypoglycemia (including low blood sugar due to diabetes medication or low blood sugar that occurs after eating)

Proglycem may be prescribed with caution in some people only if your healthcare provider determines it is safe. This includes those:

  • With high levels of uric acid
  • With a history of gout
  • With low potassium levels
  • With kidney problems
  • With high levels of bilirubin in the blood, which cause jaundice (yellowing of the skin and whites of the eyes)
  • With heart failure or problems with heart function
  • With diabetes
  • At risk for pulmonary hypertension
  • Undergoing labor and delivery

What Other Medications Interact With Proglycem?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter (OTC) medicines and vitamins or supplements. 

Proglycem is similar in structure to thiazide diuretics. Taking Proglycem with a thiazide diuretic (such as hydrochlorothiazide or a drug that contains hydrochlorothiazide) can cause increased blood sugar and uric acid levels.

Proglycem oral suspension contains alcohol and should not be combined with other suspensions containing alcohol, such as Flagyl (metronidazole), Tindamax (tinidazole), or Antabuse (disulfiram). Avoid drinking alcohol while taking Proglycem, as the combination could lower blood pressure too much.

Medications for blood pressure should be used cautiously in combination with Proglycem, as both drugs have blood pressure-lowering effects.

Other drug interactions may occur with Proglycem. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

It is important to note that Proglycem is structurally similar to thiazide diuretics, or "water pills," such as hydrochlorothiazide. However, Proglycem does not work the same and is not used to lower blood pressure.

Another medication sometimes used to treat low blood sugar is octreotide. While Proglycem is taken by mouth, octreotide is given by injection or used in a pump.

Proglycem generally differs from other medications that increase blood sugar, such as Baqsimi (glucagon). It is used regularly for low blood sugar due to certain health conditions (not including diabetes). Baqsimi and other glucagon products are used in emergency low-blood sugar situations. However, in some cases, glucagon may be used in individuals who take Proglycem if there is a low blood sugar emergency.

The drugs mentioned above are similar to Proglycem in some ways but are not the same and cannot be used as a substitution. These are NOT drugs recommended to take with Proglycem. Talk to your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Proglycem used for?

    Proglycem (diazoxide) is a prescription medicine that treats hypoglycemia (low blood sugar) due to hyperinsulinism (making too much insulin, which lowers blood sugar) caused by certain conditions.

  • How does Proglycem work?

    Proglycem prevents the pancreas from releasing insulin, which helps increase glucose (sugar) levels.

  • What drugs should not be taken with Proglycem?

    Because Proglycem is similar in structure to thiazide diuretics, taking Proglycem with a thiazide diuretic, such as hydrochlorothiazide or a drug that contains hydrochlorothiazide, can cause higher increases in blood sugar and uric acid levels.

    Proglycem oral suspension contains alcohol and should not be mixed with Flagyl (metronidazole), Tindamax (tinidazole), or Antabuse (disulfiram) because a severe reaction could occur. Proglycem should not be combined with alcohol.

    Blood pressure medications should be used cautiously in combination with Proglycem because they both decrease blood pressure. Before taking Proglycem, tell your healthcare provider about all of the medications you take.

  • How long does it take for Proglycem to work?

    Proglycem starts working within one hour and can last up to eight hours.

  • What are the side effects of Proglycem?

    Common side effects may include hair growth on the body, high blood sugar, stomach problems, loss of appetite and/or taste, fast heartbeat, palpitations, rash, headache, weakness, and feeling unwell. Other side effects may occur. Before taking Proglycem, talk to your healthcare provider about what side effects to expect and what to do if they occur.

  • How do I stop taking Proglycem?

    Your healthcare provider will advise you on how long to take Proglycem. Do not stop taking the medication without guidance from your provider.

How Can I Stay Healthy While Taking Proglycem?

While taking Proglycem, your healthcare provider will order regular blood work. It is important to keep all medical appointments and get blood work done when needed. This gives your healthcare provider information about how your body reacts to the treatment.

Your healthcare provider will tell you how to take Proglycem. Take it precisely as directed, and do not take more or less than prescribed. Before you take a new medication, whether it is prescription, over-the-counter (OTC), or a vitamin or supplement, check with your healthcare provider to make sure it is safe to take with Proglycem.

Be alert to symptoms of high blood sugar and report to your healthcare provider if they occur. Symptoms may include feeling thirsty, urinating frequently, and a fruity breath odor.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: Proglycem - diazoxide suspension.

  2. Prescribers’ Digital Reference. Diazoxide - drug summary.

  3. Chen X, Feng L, Yao H, et al. Efficacy and safety of diazoxide for treating hyperinsulinemic hypoglycemia: a systematic review and meta-analysis. PLoS One. 2021;16(2):e0246463. doi: 10.1371/journal.pone.0246463

  4. Epocrates. Proglycem.

  5. DailyMed. Label: Octreotide- octreotide acetate injection, solution.

  6. DailyMed. Label: Baqsimi- glucagon powder.

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.