Tolazamide

What is Tolazamide

Tolazamide is a ‘first-generation’ oral sulfonylurea antidiabetic agent with an intermediate duration of action.

It is used as an adjunct to diet to lower blood glucose in patients with type 2 diabetes mellitus (DM).

Although the mechanism for sulfonylureas is similar, there are quantitative differences in their individual pharmacokinetic properties.

Tolazamide tends to be mildly diuretic and, like acetohexamide, is converted into active metabolites.

Tolazamide is about 5 times more potent than tolbutamide on a milligram basis and equipotent to chlorpropamide.

Brand Name

Tolinase

Indications

  • type 2 diabetes mellitus

For adjunctive therapy in the 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. Co-Enzyme Q-10 deficiency
  8. dizziness
  9. elevated hepatic enzymes
  10. erythema
  11. erythema multiforme
  12. exfoliative dermatitis
  13. fatigue
  14. flushing
  15. headache
  16. hemolysis
  17. hemolytic anemia
  18. hepatic failure
  19. hepatitis
  20. hypoglycemia
  21. hyponatremia
  22. jaundice
  23. maculopapular rash
  24. malaise
  25. myalgia
  26. nausea
  27. pancytopenia
  28. photosensitivity
  29. porphyria
  30. pruritus
  31. pyrosis (heartburn)
  32. secondary failure
  33. SIADH
  34. thrombocytopenia
  35. urticaria
  36. vasculitis
  37. vertigo
  38. weakness
  39. weight gain

Monitoring Parameters

  • blood glucose
  • glucose-6-phosphate dehydrogenase (G6PD) activity
  • glycosylated hemoglobin A1c (HbA1c)
  • LFTs
  • serum creatinine/BUN

Contraindications

  • breast-feeding
  • children
  • diabetic ketoacidosis
  • fever
  • G6PD deficiency
  • geriatric
  • hepatic disease
  • infection
  • neonates
  • obstetric delivery
  • 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
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • atypical antipsychotic
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzphetamine
  • Beta-blockers
  • Betaxolol
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bortezomib
  • Bosentan
  • 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
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Cariprazine
  • Carteolol
  • Carvedilol
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloramphenicol
  • Chloroquine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorthalidone; Clonidine
  • Choline Salicylate; Magnesium Salicylate
  • Chromium
  • Cimetidine
  • Cisapride
  • Clarithromycin
  • Clindamycin; Tretinoin
  • Clonidine
  • Clozapine
  • Codeine; Phenylephrine; Promethazine
  • Colchicine; Probenecid
  • Colesevelam
  • Conjugated Estrogens
  • Conjugated Estrogens; Bazedoxifene
  • Conjugated Estrogens; Medroxyprogesterone
  • Corticosteroids
  • Cyclosporine
  • Daclatasvir
  • Danazol
  • Dapagliflozin; Metformin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Demeclocycline
  • Desloratadine; Pseudoephedrine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Diazoxide
  • Dienogest; Estradiol valerate
  • Diethylpropion
  • Diethylstilbestrol, DES
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Dobutamine
  • Dopamine
  • Dorzolamide; Timolol
  • Doxycycline
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Ephedrine
  • Epinephrine
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eravacycline
  • Ertugliflozin; Metformin
  • Esmolol
  • Esterified Estrogens
  • Esterified Estrogens; Methyltestosterone
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estramustine
  • Estrogens
  • Estropipate
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethotoin
  • Exenatide
  • Fenofibrate
  • Fenofibric Acid
  • Fexofenadine; Pseudoephedrine
  • Fluconazole
  • Fluocinolone; Hydroquinone; Tretinoin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluoxymesterone
  • Fosamprenavir
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Furosemide
  • Garlic, Allium sativum
  • Gemfibrozil
  • Glecaprevir; Pibrentasvir
  • 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
  • Indinavir
  • Insulin Glargine; Lixisenatide
  • Irbesartan
  • Isocarboxazid
  • Isoproterenol
  • Itraconazole
  • Ketoconazole
  • Labetalol
  • Lanreotide
  • Ledipasvir; Sofosbuvir
  • Levobetaxolol
  • Levobunolol
  • Linagliptin; Metformin
  • Linezolid
  • Lisdexamfetamine
  • Lisinopril
  • Lithium
  • Lixisenatide
  • Lomefloxacin
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Lorcaserin
  • Losartan
  • Lovastatin; Niacin
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • 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
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