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|Tolbutamide

Tolbutamide

Tolbutamide is used for:

Treating patients with type 2 diabetes who cannot control blood sugar levels by diet and exercise alone. It may be used alone or in combination with other antidiabetic medicines.

Tolbutamide is a sulfonylurea-type antidiabetic medicine. It works by stimulating the release of the body"s natural insulin from the pancreas, which in turn helps to lower blood sugar.

Do NOT use Tolbutamide if:

• you are allergic to any ingredient in Tolbutamide
• you have certain problems associated with diabetes (eg, diabetic ketoacidosis, diabetic coma); severe burns; severe acidosis; severe kidney, liver, thyroid, or endocrine problems; or type 1 diabetes
• you are in the late stages of pregnancy (at least 2 weeks before the expected delivery date)
• you are taking bosentan

Contact your doctor or health care provider right away if any of these apply to you.

Before using Tolbutamide :

Some medical conditions may interact with Tolbutamide . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have had a severe allergic reaction (eg, a severe rash, hives, breathing difficulties, or dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide
• if you have liver, kidney, thyroid, or heart problems; stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis); severe diarrhea; certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]); an electrolyte imbalance; acidosis; or high blood pressure; or you are malnourished
• if you are debilitated, have a high fever, a severe infection, have suffered from severe trauma (eg, injury), or will be having surgery

Some MEDICINES MAY INTERACT with Tolbutamide . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Bosentan because liver problems may occur and the effectiveness of both medicines may be decreased
• Birth control pills, certain asthma medicines (eg, albuterol), calcium channel blockers (eg, diltiazem), corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diet pills, diuretics (eg, furosemide, hydrochlorothiazide), epinephrine, estrogens, isoniazid, miconazole, niacin, phenothiazines (eg, chlorpromazine), rifamycins (eg, rifampin), phenytoin, or thyroid supplements (eg, levothyroxine) because the effects of Tolbutamide may be decreased
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), azole antifungals (eg, ketoconazole), beta-blockers (eg, propranolol), chloramphenicol, cimetidine, clofibrate, fenfluramine and derivatives, macrolide antibiotics (eg, erythromycin), maprotiline, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nonsteroidal anti-inflammatory medicines (eg, ibuprofen), phenylbutazone, probenecid, quinidine, quinolone antibiotics (eg, ciprofloxacin), ranitidine, salicylates (eg, aspirin), sulfinpyrazone, sulfonamides (eg, sulfamethoxazole), or urinary acidifiers (eg, tromethamine) because the risk of side effects such as low blood sugar levels may be increased
• Anticoagulants (eg, warfarin) because side effects, including risk of bleeding, may be increased by Tolbutamide
• Gemfibrozil because side effects such as increased or decreased blood sugar levels may occur
• Barbiturates (eg, phenobarbital) because side effects may be increased by Tolbutamide

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tolbutamide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Tolbutamide :

Use Tolbutamide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• If you are taking 1 dose daily, take Tolbutamide with breakfast or the first main meal of the day.
• Avoid excessive dietary fiber while taking Tolbutamide unless otherwise instructed by your health care provider.
• Take Tolbutamide regularly to receive the most benefit from it. Taking Tolbutamide at the same time each day will help you to remember to take it.
• If you miss a dose of Tolbutamide , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Tolbutamide .

Important safety information:

• Tolbutamide may cause drowsiness, dizziness, blurred vision, or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Tolbutamide . Using Tolbutamide alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• Avoid drinking alcoholic beverages while using Tolbutamide because they can increase the risk of developing hypoglycemia (low blood sugar). Rarely, alcohol can interact with Tolbutamide and cause a serious reaction (disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol.
• Tolbutamide may cause increased sensitivity to the sun. Avoid exposure to the sun or sunlamps until you know how you react to Tolbutamide . Use a sunscreen or protective clothing if you must be outside for a prolonged period.
• Be sure to follow the diet and exercise program prescribed by your health care provider.
• Carry an identification card at all times that says you are diabetic. Monitor your blood sugar levels regularly according to your doctor"s directions. If your blood sugar level is often higher than it should be and you are taking Tolbutamide according to directions, check with your doctor.
• This medicine may cause low blood sugar (eg, increased heartbeat, headache, chills, sweating, tremor, increased hunger, changes in vision, nervousness, weakness, dizziness, drowsiness, fainting). It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you do not have a reliable source of glucose available, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or nondiet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To prevent low blood sugar, eat meals on a regular schedule and do not skip meals.
• Use of similar medicines has been associated with an increased risk of heart problems. If you experience chest pain, irregular heartbeat, swelling in your hands or feet, or unusual or sudden weight gain, contact your doctor immediately. Talk to your doctor if you have any questions or concerns about taking Tolbutamide .
• Monitor blood glucose levels on a regular basis. Contact your health care provider if high or low blood sugar develops.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are taking Tolbutamide .
• During times of stress, such as fever, infection, injury, or surgery, it may be more difficult to control your blood sugar. Do not change the dose of your medicine without first talking with your doctor.
• LAB TESTS, including liver function, kidney function, fasting blood glucose, glycosylated hemoglobin, and complete blood cell counts, may be performed to monitor your progress or to check for side effects. Keep all doctor and lab appointments while you are taking Tolbutamide .
• Use caution in the ELDERLY because they may be more sensitive to the effects of Tolbutamide , especially abnormally low blood sugar levels.
• Use Tolbutamide with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: It is unknown if Tolbutamide can cause harm to the fetus. If you become pregnant, discuss with your doctor the benefits and risks of taking Tolbutamide during pregnancy. If Tolbutamide is taken during pregnancy, it should be stopped at least 2 weeks before the expected delivery date to minimize the risk of severe low blood sugar in the newborn infant. It is unknown if Tolbutamide is excreted in breast milk. Do not breast-feed while taking Tolbutamide .

Possible side effects of Tolbutamide :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; heartburn; loss of appetite; nausea; stomach fullness; vomiting.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; skin redness; dizziness; itching); blistered, reddened, or swollen skin; chest pain or irregular heartbeat; dark urine; easy bleeding or bruising; mental/mood changes; persistent sore throat or fever; seizures; stomach pain; swelling of the hands or feet; symptoms of low blood sugar (eg, tiredness, tremor, nervousness, jitteriness, dizziness); unusual or sudden weight gain; unusual tiredness or weakness; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; confusion; lethargy and impaired consciousness; lightheadedness; loss of consciousness; mild stomach pain; nausea; rapid pulse; seizures; sweating; tingling of the lips and tongue; tremor; vomiting.

Store Tolbutamide between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tolbutamide out of the reach of children and away from pets.

General information:

• If you have any questions about Tolbutamide , please talk with your doctor, pharmacist, or other health care provider.
• Tolbutamide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Tolbutamide . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.