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
- agranulocytosis
- angioedema
- aplastic anemia
- arthralgia
- blurred vision
- cholestasis
- Co-Enzyme Q-10 deficiency
- dizziness
- elevated hepatic enzymes
- erythema
- erythema multiforme
- exfoliative dermatitis
- fatigue
- flushing
- headache
- hemolysis
- hemolytic anemia
- hepatic failure
- hepatitis
- hypoglycemia
- hyponatremia
- jaundice
- maculopapular rash
- malaise
- myalgia
- nausea
- pancytopenia
- photosensitivity
- porphyria
- pruritus
- pyrosis (heartburn)
- secondary failure
- SIADH
- thrombocytopenia
- urticaria
- vasculitis
- vertigo
- weakness
- 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
