Classes
DEA Class; Rx
Common Brand Names; Orinase
- Antidiabetics, Sulfonylureas
Description
First-generation oral sulfonylurea; least potent and shortest-acting sulfonylurea; lacks active metabolites
Used in adults for the treatment of type 2 diabetes mellitus; however, second-generation agents are preferred
May be useful in the elderly or patients with renal disease
Indications
Indicated for adjunctive treatment of type 2 diabetes mellitus not controlled by diet and exercise alone.
Contraindications
Hypersensitivity, sulfa allergy
Type I diabetes, diabetic ketoacidosis
Adverse Effects
- Hypoglycemia
- Dermatologic recations
- Disulfiram-like reactions
- Agranulocytosis
- Hyponatremia
- Aplastic anemia
- Thrombocytopenia
- Heartburn
- Nausea/vomiting
- Cholestatic jaundice and hepatitis may occur rarely which may progress to liver failure
Warnings
Patients with hypoglycemia, when caloric intake is decreased or there is increased stress due to infection, fever, trauma, or surgery (may need to discontinue treatment)
Risk of cardiovascular mortality increases with oral hypoglycemic drug treatments compared to treatment with diet alone or diet plus insulin
Risk of sulfonylurea-induced hemolytic anemia may increase in patients iwth glucose-6-phosphate dehydrogenase deficiency
Pregnancy and Lactation
Pregnancy Category: C
Lactation: Controversial, avoid
Maximum Dosage
3,000 mg/day PO.
3,000 mg/day PO.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Tolbutamide
tablet
- 25mg
- 50mg
- 100mg