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Orinase, |tolbutamide

tolbutamide

Generic Name: tolbutamide (tole BYOO ta mide)
Brand Names: Orinase

What is tolbutamide?

Tolbutamide is in a class of drugs called sulfonylureas. It is used to help control blood sugar levels.

Tolbutamide is used with diet and exercise to treat type 2 diabetes mellitus. Insulin or metformin (Glucophage) may also be used in combination with tolbutamide, if necessary.

Tolbutamide may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about tolbutamide?

Treatment with tolbutamide may increase the risk of death from cardiovascular disease compared to treatment of diabetes with diet alone or diet plus insulin. Discuss with your doctor the risks and benefits of treatment with tolbutamide.

Know the signs and symptoms of low blood sugar (hypoglycemia), which include headache, drowsiness, weakness, dizziness, fast heartbeat, sweating, tremor, and nausea. Carry a piece of hard candy or glucose tablets with you to treat episodes of low blood sugar.

Follow your diet, medication, and exercise routines closely. Changing any of them can affect blood sugar levels.

What should I discuss with my healthcare provider before taking tolbutamide?

Before taking tolbutamide, tell your doctor if you

• have kidney disease;
• have liver disease;

• have thyroid disease;

• have type 1 diabetes;

• have 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.

Patients 65 years of age and older may have a stronger reaction to tolbutamide and may require a reduced dose.

How should I take tolbutamide?

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.

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.

Your healthcare provider may recommend regular monitoring of blood sugar levels with blood or urine tests.

What happens if I miss 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 happens if I overdose?

Symptoms of a tolbutamide overdose include hunger, nausea, anxiety, cold sweats, weakness, drowsiness, unconsciousness, and coma.

What should I avoid while taking tolbutamide?

Follow your diet, medication, and exercise routines closely. Changing any of these can affect blood sugar levels.

Tell your doctor and dentist that you are taking this medication before you undergo surgery.

Tolbutamide side effects

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:

• shaking;

• headache;

• cold sweats;

• pale, cool skin;

• anxiety; and

• difficulty concentrating.

Keep hard, sugary candy; chocolate; fruit juice; or glucose tablets on hand to treat episodes of low blood sugar.

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, and

• 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 other drugs will affect tolbutamide?

Many other 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 medicines:

• 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.

Drugs other than those listed here may also interact with tolbutamide or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

• Your pharmacist has additional information about tolbutamide written for health professionals that you may read.

What does my medication look like?

Tolbutamide is available with a prescription under the brand name Orinase. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.