Tolbutamide is a first-generation potassium channel blocker, sulfonylurea oral hypoglycemic medication.
The reference site for Tolbutamide
WHAT IS Tolbutamide?
Tolbutamide is in a class of drugs called sulfonylureas. It is used to help control blood sugar levels, together with diet and exercise to treat type II diabetes mellitus. Insulin or metformin (Glucophage®) may also be used in combination with tolbutamide, if necessary.
This medication works by lowering blood sugar by stimulating the pancreas to secrete insulin and helping the body use insulin efficiently. The pancreas must produce insulin for this drug to work. Tolbutamide is not used to treat type I (insulin-dependent) diabetes (formerly ‘juvenile-onset’).
Tolbutamide is sold under the brand name Orinase®.
Brand Name(s): Orinase
CAS nº: 64-77-7
(tole BYOO ta mide)
The sections below will provide you with more specific information and guidelines related to tolbutamide and its correct use. Please read them carefully.
Tolbutamide, the first widely used sulfonylurea, was approved by the FDA in 1957. It is available with a prescription under the brand name Orinase®.
Why is this medication prescribed?
This medication lowers blood sugar by stimulating the pancreas to secrete insulin and helping the body use insulin efficiently. The pancreas must produce insulin for this drug to work. Tolbutamide is not used to treat type I (insulin-dependent) diabetes (formerly ‘juvenile-onset’).
Tolbutamide is in a class of drugs called sulfonylureas. It is used together with diet and exercise to help control blood sugar levels and treat type II diabetes mellitus.
Insulin or metformin (Glucophage®) may also be used in combination with tolbutamide, if necessary.
Other uses for this medicine
This medication has not been approved for any alternative uses other than those mentioned in the product information section.
Dosage and using this medicine
Tolbutamide comes in tablets to be taken orally.
Take tolbutamide exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass of water.
Tolbutamide is usually taken before breakfast or the first main meal if it is taken once a day, or before meals if it is taken multiple times each day. Follow your doctor’s instructions.
It is important to take tolbutamide regularly to get the most benefit.
Additionally, your healthcare provider may recommend regular monitoring of blood sugar levels with blood or urine tests.
Do not change your dose of tolbutamide without first talking to your doctor.
What special precautions should I follow?
BEFORE TAKING TOLBUTAMIDE:
Tell your doctor if you have kidney disease, liver disease, thyroid disease, type 1 diabetes, a serious infection, illness, or injury, or need surgery. You may not be able to take tolbutamide, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Moreover, many medicines may increase or decrease the effects of tolbutamide or affect your condition. Before taking tolbutamide, tell your doctor if you are taking any of the following medications: aspirin or another salicylate such as magnesium/choline salicylate (Trilisate®), salsalate (Disalcid®, others), choline salicylate (Arthropan®), magnesium salicylate (Magan®), or bismuth subsalicylate (Pepto-Bismol®); a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin®, Advil®, Nuprin®, others), ketoprofen (Orudis®, Orudis KT®, Oruvail®), diclofenac (Voltaren®, Cataflam®), etodolac (Lodine®), indomethacin (Indocin®), nabumetone (Relafen®), oxaprozin (Daypro®), naproxen (Anaprox®, Naprosyn®, Aleve®), and others; a sulfa-based drug such as sulfamethoxazole-trimethoprim (Bactrim®, Septra®), sulfisoxazole (Gantrisin®), or sulfasalazine (Azulfidine®); a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan®), tranylcypromine (Parnate®), or phenelzine (Nardil®); a beta-blocker such as propranolol (Inderal®), atenolol (Tenormin®), acebutolol (Sectral®), metoprolol (Lopressor®), and others; a diuretic (water pill) such as hydrochlorothiazide (HCTZ®, Hydrodiuril®), chlorothiazide (Diuril®), and others; a steroid medicine such as prednisone (Deltasone®, Orasone®, others), methylprednisolone (Medrol®, others), prednisolone (Prelone®, Pediapred®, others), and others; a phenothiazine such as chlorpromazine (Thorazine®), fluphenazine (Prolixin®, Permitil®), prochlorperazine (Compazine®), promethazine (Phenergan®), and others; phenytoin (Dilantin®); isoniazid (Nydrazid®); or prescription, over-the-counter, or herbal cough, cold, allergy, or weight loss medications. You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
Patients 65 years of age and older may have a stronger reaction to tolbutamide and may require a reduced dose.
Tolbutamide is in the FDA pregnancy category C. This means that it is not known whether tolbutamide will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. Insulin is usually the drug of choice for controlling diabetes during pregnancy.
More importantly, tolbutamide passes into breast milk and may cause hypoglycemia (low blood sugar) in a nursing baby. Do not take tolbutamide without first talking to your doctor if you are breast-feeding a baby.
Follow your diet, medication, and exercise routines closely. Changing any of these can affect blood sugar levels.
Additionally, try to avoid alcohol intake, as it lowers blood sugar and may interfere with your diabetes treatment.
What should I do if I forget a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose.
Do not take a double dose of this medication.
What side effects can this medication cause?
Stop taking tolbutamide and seek emergency medical attention if you experience an allergic reaction (such as difficulty breathing, closing of the throat, swelling of the lips, tongue, or face, or hives).
Other, less serious side effects from tolbutamide result mostly from blood sugar levels that are either too high or too low. You should be familiar with the symptoms of both high and low blood sugar levels and know how to treat both conditions. Also, be sure your family and close friends know how to help you in an emergency situation.
Low blood sugar may occur when too much tolbutamide is taken, when meals are missed or delayed, if you exercise more than usual, during illness, especially with vomiting or diarrhea, if you take other medications, after drinking alcohol, and in other situations.
Hypoglycemia or low blood sugar has the following symptoms:
– cold sweats
– pale, cool skin
– difficulty concentrating
Keep hard, sugary candy, chocolate, fruit juice, or glucose tablets at hand to treat episodes of low blood sugar.
On the other hand, increased blood sugar may occur when not enough tolbutamide is taken, if you eat significantly more food than usual, if you exercise less than usual, if you take other medications, during fever or other illness, and in other situations.
Hyperglycemia or high blood sugar has the following symptoms:
– increased thirst
– increased hunger
– increased urination
There may be an increased risk of death due to cardiovascular (heart and blood vessels) complications with the use of tolbutamide when compared to the treatment of diabetes with diet or diet plus insulin. The long-term use of tolbutamide should be discussed with your doctor.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What storage conditions are needed for this medicine?
Always try to keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Remeber to throw away any medication that is outdated or no longer needed. If you have any questions, please talk to your pharmacist about the proper disposal of your medication.
In case of an emergency/overdose
In the case of an overdose, call your local poison control center on 1-800-222-1222. However, if the victim has collapsed or is not breathing, then please call the local emergency services on 911.
Symptoms of overdose may include:
PICTURES OF TOLBUTAMIDE PILLS
Below you will find images and specific information on the principal types of tolbutamide that exist, including their respective brand name(s), strength, inscription codes, manufacturers and/or distributors.
The information below includes general information and guidelines for patients taking this medication and should never be used to substitute professional medical advice that can be provided by a qualified physician or family doctor.
Strength(s): 500 MG
Imprint: ORINASE 500
Manufacturer: PHARMACIA / UPJHN
Strength(s): 500 MG
Imprint: APO TOL
Manufacturer: APOTEX INC.