tolbutamide and Adapin Interactions

Interactions between tolbutamide(TOLBUTamide) and Adapin (doxepin)

doxepin and TOLBUTamide (Moderate Drug-Drug)

MONITOR: Case reports suggest that tricyclic antidepressants may increase the hypoglycemic effects of sulfonylureas. The mechanism is unknown. Causality has not been definitely determined and one small trial demonstrated no pharmacokinetic changes with amitriptyline and tolbutamide.

MANAGEMENT: Patients receiving this combination should be advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs. The sulfonylurea dosage may require reduction in affected patients.