Tolbutamide Dosage
This dosage information may not include all the information needed to use Tolbutamide safely and effectively. See additional information for Tolbutamide.
The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Diabetes Mellitus Type II
Initial dose: 1 to 2 grams orally daily
Maintenance dose: 0.25 to 3 grams orally daily
Renal Dose Adjustments
Consider the lowest possible initial and maintenance dose to avoid hypoglycemia.
Liver Dose Adjustments
Consider the lowest possible initial and maintenance dose to avoid hypoglycemia.
Dose Adjustments
Patients requiring 20 to 40 units of insulin daily may be initiated on tolbutamide, with a 30% to 50% reduction in insulin for the first few days, and with subsequent reductions dependent upon the response. In addition, patients requiring more than 40 units of insulin daily may be started on tolbutamide with a 20% reduction in insulin the first day, and with subsequent reductions based on response.
Precautions
Patients with impaired renal or hepatic function, the elderly, and debilitated or malnourished patients are at an increased risk of hypoglycemia and tolbutamide should be used with caution. During the initial period of therapy with tolbutamide 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 3 g/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.
The total daily dose may be taken either in the morning or in divided doses throughout the day. Gastrointestinal intolerance may be reduced by dividing the dose.
