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Tolbutamide

Tolbutamide

Description

Tolbutamide is an oral antihyperglycemic agent used for the treatment of non-insulin-dependent diabetes mellitus (NIDDM). It is structurally similar to acetohexamide, chlorpropamide and tolazamide and belongs to the sulfonylurea class of insulin secretagogues, which act by stimulating β cells of the pancreas to release insulin. Sulfonylureas increase both basal insulin secretion and meal-stimulated insulin release. Medications in this class differ in their dose, rate of absorption, duration of action, route of elimination and binding site on their target pancreatic β cell receptor. Sulfonylureas also increase peripheral glucose utilization, decrease hepatic gluconeogenesis and may increase the number and sensitivity of insulin receptors. Sulfonylureas are associated with weight gain, though less so than insulin. Due to their mechanism of action, sulfonylureas may cause hypoglycemia and require consistent food intake to decrease this risk. The risk of hypoglycemia is increased in elderly, debilitated and malnourished individuals. Tolbutamide appears to be metabolized in the liver. Tolbutamide and its metabolites are excreted in urine (75-85%) and feces.

Uses

Tolbutamide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Tolbutamide belongs to the class of drugs known as sulfonylureas. It works by causing the release of your body's natural insulin and may help to restore your body's proper response to insulin.

Dosages

Oral dosage

Adults:Initially, 1000—2000 mg/day PO, given in 1—3 divided doses (available as 500 mg tablets). The usual dosage range is 250—2000 mg/day PO. Maximum dosage is 3000 mg/day PO.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include hypoglycemia symptoms as well as the following:

  • seizures
  • loss of consciousness

Geriatric

See adult dosage. Since tolbutamide has a relatively short half-life and is metabolized to inactive metabolites, it may have a safety advantage (vs. longer-acting agents) for the treatment of elderly patients.

What should I do if I forget a dose?

Before you start to take tolbutamide, ask you doctor what you should do if you forget to take a dose. Write these directions down so that you can refer to them later.

This medication can cause low blood sugar (hypoglycemia). This may occur if you do not consume enough calories from food or if you do unusually heavy exercise. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.

STORAGE

  • Orinase:Store at room temperature (between 59 to 86 degrees F)
  • Tol-Tab :Store at room temperature (between 59 to 86 degrees F)
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