Acetohexamide

Acetohexamide Brand Name

Dymelor

What is Acetohexamide

NOTE: This drug is discontinued in the U.S.

Acetohexamide was a first-generation oral sulfonylurea.

It was used, as an adjunct to diet and exercise, to lower blood glucose in patients with type 2 diabetes mellitus.

Similar hypoglycemic efficacy occurs with equipotent dosage of sulfonylureas. Sulfonylurea antidiabetic agents exhibit similar hypoglycemic mechanisms, although there are quantitative differences in their individual pharmacokinetic properties.

The duration of action of acetohexamide is about 12 to 18 hours.

Acetohexamide is metabolized to a more potent active metabolite which is primarily renally eliminated; the active metabolite accounts for the prolonged effects of acetohexamide relative to the parent drug’s short half-life.

Acetohexamide is contraindicated for use in patients with significant renal impairment.

In addition, acetohexamide exhibits uricosuric activity, which made the drug potentially useful for diabetic patients with gout.

Acetohexamide was FDA approved in 1964.

The drug was removed from marketing in the U.S. in the 1990’s.

Indications

• type 2 diabetes mellitus

For treatment of type 2 diabetes mellitus not controlled by diet and exercise alone

Side Effects

1. agranulocytosis
2. angioedema
3. aplastic anemia
4. arthralgia
5. blurred vision
6. cholestasis
7. dizziness
8. elevated hepatic enzymes
9. erythema
10. erythema multiforme
11. exfoliative dermatitis
12. fatigue
13. flushing
14. headache
15. hemolysis
16. hemolytic anemia
17. hepatic failure
18. hepatitis
19. hypoglycemia
20. hyponatremia
21. jaundice
22. leukopenia
23. maculopapular rash
24. myalgia
25. nausea
26. pancytopenia
27. photosensitivity
28. porphyria
29. pruritus
30. pyrosis (heartburn)
31. secondary failure
32. SIADH
33. thrombocytopenia
34. urticaria
35. vasculitis
36. weakness
37. weight gain

Monitoring Parameters

• blood glucose
• glucose-6-phosphate dehydrogenase (G6PD) activity
• glycosylated hemoglobin A1c (HbA1c)

Contraindications

• breast-feeding
• children
• diabetic ketoacidosis
• fever
• geriatric
• hepatic disease
• infection
• neonates
• obstetric delivery
• porphyria
• pregnancy
• renal disease
• renal failure
• renal impairment
• sulfonamide hypersensitivity
• sulfonylurea hypersensitivity
• surgery
• thyroid disease
• trauma
• type 1 diabetes mellitus

Interactions

• Acebutolol
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Pseudoephedrine
• Acitretin
• Acrivastine; Pseudoephedrine
• Aliskiren; Valsartan
• Alogliptin; Metformin
• Aminolevulinic Acid
• Amiodarone
• Amlodipine; Benazepril
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amprenavir
• Androgens
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Aripiprazole
• Articaine; Epinephrine
• Asenapine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
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• atypical antipsychotic
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• Betaxolol
• Bexarotene
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• Bortezomib
• Brexpiprazole
• Brimonidine; Timolol
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Bumetanide
• Canagliflozin; Metformin
• Candesartan
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
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• Carbinoxamine; Pseudoephedrine
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• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorthalidone; Clonidine
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• Chromium
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• Garlic, Allium sativum
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• Glimepiride; Rosiglitazone
• Glipizide; Metformin
• Glyburide; Metformin
• Green Tea
• Griseofulvin
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Phenylephrine
• Guaifenesin; Pseudoephedrine
• Halobetasol; Tazarotene
• Hydantoins
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydroxychloroquine
• Ibuprofen; Pseudoephedrine
• Iloperidone
• Indapamide
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• Insulin Glargine; Lixisenatide
• Irbesartan
• Isocarboxazid
• Isoproterenol
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• Ketoconazole
• Labetalol
• Lanreotide
• Ledipasvir; Sofosbuvir
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• Levobunolol
• Linagliptin; Metformin
• Linezolid
• Lisdexamfetamine
• Lisinopril
• Lithium
• Lixisenatide
• Lomefloxacin
• Lopinavir; Ritonavir
• Loratadine; Pseudoephedrine
• Lorcaserin
• Losartan
• Lovastatin; Niacin
• Lumateperone
• Lurasidone
• Magnesium Salicylate
• Mecasermin rinfabate
• Mecasermin, Recombinant, rh-IGF-1
• Mepivacaine; Levonordefrin
• Mequinol; Tretinoin
• Mestranol; Norethindrone
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methamphetamine
• Methotrexate
• Methoxsalen
• Methylphenidate
• Methyltestosterone
• Metoprolol
• Metreleptin
• Metyrapone
• Miconazole
• Midodrine
• Minocycline
• Moexipril
• Monoamine oxidase inhibitors
• Nadolol
• Nandrolone Decanoate
• Naproxen; Pseudoephedrine
• Nebivolol
• Nebivolol; Valsartan
• Nelfinavir
• Niacin, Niacinamide
• Niacin; Simvastatin
• Nicotine
• Nitazoxanide
• Nonsteroidal antiinflammatory drugs
• Norepinephrine
• Octreotide
• Olanzapine
• Olmesartan
• Omadacycline
• Ombitasvir; Paritaprevir; Ritonavir
• Orlistat
• Oxandrolone
• Oxymetholone
• Paliperidone
• Pasireotide
• Pegvisomant
• Pemoline
• Penbutolol
• Pentamidine
• Pentoxifylline
• Perindopril
• Perindopril; Amlodipine
• Phendimetrazine
• Phenelzine
• Phenothiazines
• Phentermine
• Phentermine; Topiramate
• Phenylephrine
• Phenylephrine; Promethazine
• Phenytoin
• Photosensitizing agents (topical)
• Pindolol
• Porfimer
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prilocaine; Epinephrine
• Probenecid
• Progestins
• Propranolol
• Protease inhibitors
• Pseudoephedrine
• Quetiapine
• Quinapril
• Quinolones
• Racepinephrine
• Ramipril
• Ranitidine
• Reserpine
• Rifamycins
• Risperidone
• Ritodrine
• Ritonavir
• Rosiglitazone
• Sacubitril; Valsartan
• Salsalate
• Saquinavir
• Sarecycline
• Segesterone Acetate; Ethinyl Estradiol
• Selegiline
• Sofosbuvir
• Sofosbuvir; Velpatasvir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• Somatropin, rh-GH
• Sotalol
• Sparfloxacin
• Sulfacetamide
• Sulfacetamide; Sulfur
• Sulfinpyrazone
• Sulfonamides
• Sympathomimetics
• Tacrolimus
• Tazarotene
• Tegaserod
• Telmisartan
• Testolactone
• Testosterone
• Tetracycline
• Tetracyclines
• Thiazide diuretics
• Thyroid hormones
• Timolol
• Tipranavir
• tobacco
• Torsemide
• Trandolapril
• Trandolapril; Verapamil
• Tranylcypromine
• Tretinoin, ATRA
• Triamterene
• Trovafloxacin, Alatrofloxacin
• Valsartan
• Verteporfin
• Voriconazole
• Warfarin
• Ziprasidone