Tolbutamide

Tolbutamide is a prescription medication used for the treatment of type 2 diabetes. 

• Tolbutamide is available under the following different brand names: Tolinase

Common side effects of Tolbutamide include:

• Nausea
• Upper abdominal fullness
• Heartburn
• Rash
• Headache
• Changes in taste

Serious side effects of Tolbutamide include:

• Yellowing of the skin or eyes
• Light-colored stools
• Dark urine
• Pain in the upper right part of the stomach
• Unusual bruising or bleeding
• Diarrhea
• Fever
• Sore throat

Rare side effects of Tolbutamide include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet

• 500 mg

Type 2 Diabetes

Adult dosage and geriatric dosage

• 250 mg-2 g orally once a day or every 8-12 hours; not to exceed 3 g/day; maintenance dose above 2 g/day seldom required

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Tolbutamide has no noted severe interactions with any other drugs.
• Tolbutamide has serious interactions with the following drugs:
  • aminolevulinic acid oral
  • aminolevulinic acid topical
  • erdafitinib
  • ethanol
  • ivosidenib
  • lumacaftor/ivacaftor
  • methyl aminolevulinate
  • siponimod
• Tolbutamide has moderate interactions with at least 167 other drugs.
• Tolbutamide has minor interactions with at least 121 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity, sulfa allergy
• Type I diabetes, diabetic ketoacidosis

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Tolbutamide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Tolbutamide?”

Cautions

• 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 with glucose-6-phosphate dehydrogenase deficiency

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Controversial, avoid