Generic Name: tolbutamide (tole-BUE-ta-mide)
Brand Name: Generic only. No brands available.
Tolbutamide is used for:
Treating type 2 diabetes in patients 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 severe problems associated with diabetes (eg, diabetic ketoacidosis, diabetic coma)
- you have moderate to severe burns, or very high blood acid levels (acidosis)
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, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide
- if you have a history of liver, kidney, thyroid, or heart problems
- if you have stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis), drink alcohol, or have had poor nutrition
- if you have type 1 diabetes, very poor health, a high fever, a severe infection, severe diarrhea, or high blood acid levels, or have had a severe injury
- if you have a history of certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]), or low blood sodium levels
- if you 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:
- Beta-blockers (eg, propranolol) because the risk of low blood sugar may be increased. They may also hide certain signs of low blood sugar and make it more difficult to notice
- Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), anticoagulants (eg, warfarin), azole antifungals (eg, miconazole, ketoconazole), chloramphenicol, clofibrate, fenfluramine, insulin, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nonsteroidal anti-inflammatory medicines (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), sulfinpyrazone, or sulfonamides (eg, sulfamethoxazole) because the risk of low blood sugar may be increased
- Calcium channel blockers (eg, diltiazem), corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, hormonal contraceptives (eg, birth control pills), isoniazid, niacin, phenothiazines (eg, promethazine), phenytoin, rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, epinephrine, terbutaline), or thyroid supplements (eg, levothyroxine) because they may decrease tolbutamide's effectiveness, resulting in high blood sugar
- Gemfibrozil because blood sugar may be increased or decreased
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.
- Take tolbutamide by mouth with food as directed by your doctor.
- Tolbutamide works best if it is taken at the same time each day.
- Continue to take tolbutamide even if you feel well. Do not miss any doses.
- 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. 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. These effects may be worse if you take it with alcohol or certain medicines. Use tolbutamide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol while you are taking tolbutamide. It may increase the risk of low blood sugar. Rarely, alcohol may interact with tolbutamide and cause a serious reaction with symptoms such as flushing, nausea, vomiting, dizziness, or stomach pain. Discuss any questions or concerns with your doctor.
- Carry an ID card at all times that says you have diabetes. Check your blood sugar levels as directed by your doctor. If they are often higher or lower than they should be and you take tolbutamide exactly as prescribed, tell your doctor.
- Proper diet, regular exercise, and regular blood sugar testing are important for best results with tolbutamide. Follow the diet and exercise program given to you by your health care provider.
- It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.
- Tolbutamide may cause low blood sugar levels. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
- Risk of low blood sugar may be increased by severe or prolonged exercise, drinking alcohol, or skipping meals.
- Tolbutamide is a sulfonylurea. It may increase the risk of death from heart disease. Talk with your doctor about the benefits and risks of this or other therapies to treat your condition.
- Tolbutamide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to tolbutamide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Tolbutamide should not be used by itself to treat type 1 diabetes. If you have questions about using tolbutamide to treat type 1 diabetes, talk with your doctor.
- Tell your doctor or dentist that you take tolbutamide before you receive any medical or dental care, emergency care, or surgery.
- Tolbutamide may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using tolbutamide.
- Lab tests, including fasting blood glucose and hemoglobin A1C, may be performed while you use tolbutamide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use tolbutamide with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sugar levels.
- Tolbutamide should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using tolbutamide while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking tolbutamide.
When used for long periods of time, tolbutamide may not work as well. If your blood sugar has been under control and then becomes hard to manage, contact your doctor. Do not change the dose of your medicine without checking with your doctor.
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:
Seek medical attention right away if any of these SEVERE side effects occur:
Feeling of stomach fullness; heartburn; nausea.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; dark urine; fainting; fever, chills, or persistent sore throat; irregular heartbeat; low blood sugar symptoms (eg, anxiety, dizziness, drowsiness, fast heartbeat, headache, lightheadedness, tremors, unusual sweating, weakness); severe or persistent blurred vision or other vision problems; unusual bruising or bleeding; unusual tiredness or weakness; yellowing of the eyes or skin.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include coma; confusion; fainting; fast heartbeat; lethargy; lightheadedness; seizures; severe dizziness or drowsiness; tremor; unusual sweating.Proper storage of tolbutamide:
Store tolbutamide at room temperature, between 68 and 77 degrees F (20 and 25 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.
- 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.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take tolbutamide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about tolbutamide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to tolbutamide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using tolbutamide.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
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- Drug class: sulfonylureas