Tolazamide Dosage

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Usual Adult Dose for:

Usual Geriatric Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Initial dose: 100 mg to 250 mg orally daily with breakfast
Maintenance dose: 100 mg to 1000 mg orally daily with a meal in 1 or 2 divided doses. Dosage adjustments should be made in increments of 100 mg to 250 mg at weekly intervals based on the patient's blood glucose response.

Usual Geriatric Dose for Diabetes Type 2

Initial dose: 100 mg orally daily with breakfast

Renal Dose Adjustments

CrCl less than 80 mL/min:
Initial dose: 100 mg orally daily with breakfast

Liver Dose Adjustments

Initial dose: 100 mg orally daily with breakfast

Dose Adjustments

Patients requiring more than 40 units of insulin daily may be initiated on tolazamide 250 mg orally daily, with a 50% reduction in insulin for the first few days, and with subsequent reductions dependent upon the response.

Precautions

Patients with impaired renal or hepatic function, the elderly, and debilitated or malnourished patients are at an increased risk of hypoglycemia and tolazamide should be used with caution. During the initial period of therapy with tolazamide hypoglycemic reactions may occasionally occur, particularly during the transition from insulin to the oral drug.

Patients transferred from oral hypoglycemic agents other than chlorpropamide require no transition period or priming dose. Caution is recommended when transferring from chlorpropamide to avoid hypoglycemia.

Safety and efficacy in pediatric patients have not been established.

Dialysis

Data not available

Other Comments

The maximum dose is 1000 mg/day. In addition to the usual monitoring of urinary glucose, the patient's blood glucose must also be monitored periodically to determine the minimum effective dose for the patient, to detect primary failure, i.e., inadequate lowering of blood glucose at the maximum recommended dose of medication, and to detect secondary failure, i.e., loss of an adequate blood glucose lowering response after an initial period of effectiveness. Glycosylated hemoglobin levels may also be of value in monitoring the patient's response to therapy.

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