Indications: chronic intractable hypoglycaemia.

Cautions: impaired cardiac or cerebral circulation; heart failure; aortic coarctation; aortic stenosis; arteriovenous shunt; monitor blood pressure; hyperuricaemia; during prolonged use monitor white cell and platelet count.

Renal impairment: dose reduction may be required.

Pregnancy: use only if essential; alopecia and hypertrichosis reported in neonates with prolonged use; may inhibit uterine activity during labour.

Breast feeding: manufacturer advises avoid—no information available.

Side Effects: nausea, vomiting, abdominal pain, diarrhoea, constipation, ileus, pancreatitis, anorexia (prolonged use), taste disturbance, bleeding, heart failure, hypotension, pulmonary hypertension, dyspnea, extrapyramidal effects, headache, dizziness, galactorrhoea, hyperglycaemia, decreased libido, leucopenia, thrombocytopenia, anaemia, eosinophilia, hyperosmolar non-ketotic coma, raised serum creatinine and urea, reversible nephritic syndrome, sodium and fluid retention, hyperuricaemia (prolonged use), musculoskeletal pain, visual disturbances, transient cataracts, lacrimation, tinnitus, hypertrichosis, pruritus, dermatitis, lichenoid eruption.

Dose: By mouth, ADULT, initially 5 mg/kg daily in 2–3 divided doses, then adjusted according to response Maintenance, usual maintenance dose 3–8 mg/kg daily in 2–3 divided doses