What is Tolbutamide
Tolbutamide is a ‘first-generation’ oral sulfonylurea antidiabetic agent used as an adjunct to diet to control blood glucose in patients with type 2 diabetes mellitus (DM).
Tolbutamide is the shortest-acting and least potent sulfonylurea; its duration of action is 6 to 12 hours.
Since it is extensively metabolized to inactive metabolites, tolbutamide may be useful in the treatment of elderly patients or patients with renal disease.
Brand Name
- Orinase
- Tol-Tab
Side Effects
- agranulocytosis
- angioedema
- aplastic anemia
- arthralgia
- blurred vision
- cholestasis
- dizziness
- dysgeusia
- elevated hepatic enzymes
- erythema
- fatigue
- flushing
- headache
- hemolysis
- hemolytic anemia
- hepatic failure
- hepatitis
- hypoglycemia
- hyponatremia
- jaundice
- leukopenia
- maculopapular rash
- myalgia
- nausea
- pancytopenia
- photosensitivity
- porphyria
- pruritus
- pyrosis (heartburn)
- secondary failure
- SIADH
- thrombocytopenia
- urticaria
- vasculitis
- weakness
- weight gain
Monitoring Parameters
- blood glucose
- glucose-6-phosphate dehydrogenase (G6PD) activity
- glycosylated hemoglobin A1c (HbA1c)
- LFTs
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
- trauma
- type 1 diabetes mellitus
- uremia
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
- Alpelisib
- 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
- Cannabidiol
- 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
- Delavirdine
- 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
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- 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
- Fluvoxamine
- 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; Methyldopa
- 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
- Imatinib
- Indapamide
- Indinavir
- Insulin Glargine; Lixisenatide
- Irbesartan
- Isocarboxazid
- Isoproterenol
- Itraconazole
- Ivacaftor
- Ivosidenib
- Ketoconazole
- Labetalol
- Lanreotide
- Ledipasvir; Sofosbuvir
- Leflunomide
- 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
- Methyldopa
- 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
- Nitisinone
- Nonsteroidal antiinflammatory drugs
- Norepinephrine
- Octreotide
- Olanzapine
- Olmesartan
- Omadacycline
- Ombitasvir; Paritaprevir; Ritonavir
- Oritavancin
- 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
- Rucaparib
- Sacubitril; Valsartan
- Salsalate
- Saquinavir
- Sarecycline
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Sodium Iodide
- Sofosbuvir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Somatropin, rh-GH
- Sotalol
- Sparfloxacin
- St. John’s Wort, Hypericum perforatum
- Sulfacetamide
- Sulfacetamide; Sulfur
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfinpyrazone
- Sulfonamides
- Sympathomimetics
- Tacrolimus
- Tazarotene
- Tegaserod
- Telmisartan
- Teniposide
- Testolactone
- Testosterone
- Tetracycline
- Tetracyclines
- Tezacaftor; Ivacaftor
- Thiazide diuretics
- Thyroid hormones
- Timolol
- Tipranavir
- tobacco
- Torsemide
- Trandolapril
- Trandolapril; Verapamil
- Tranylcypromine
- Tretinoin, ATRA
- Triamterene
- Trimethoprim
- Trovafloxacin, Alatrofloxacin
- Valproic Acid, Divalproex Sodium
- Valsartan
- Vemurafenib
- Verteporfin
- Voriconazole
- Warfarin
- Zafirlukast
- Ziprasidone
