Tolbutamide

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Molecule Description

Tolbutamide is an oral hypoglycemic medicine that is used to control blood sugar levels in patients of Type 2 Diabetes Mellitus.

Uses

Type 2 Diabetes Mellitus

Contraindications

When should one not use Tolbutamide

Allergic to Tolbutamide
Diabetic ketoacidosis (a complication of diabetes with rapid weight loss, nausea or vomiting)
Diabetic coma
Severe kidney, liver, thyroid or adrenal gland disease
Unusual stressful conditions
Porphyria (a hereditary disorder affecting the liver or bone marrow)

Side effects

Common side effects of this drug are:

Sudden sweating
Shaking
Faster heartbeat
Blurred vision
Unsteadiness
Tingling in hands and feet
Dark-colored urine
Easy bruising and bleeding
Abdominal pain
Constipation
Yellow skin or eyes
Disturbances in liver function
Sensitivity to light, skin rashes
Anaemia
Low blood sugar

Precautions and Warnings

Pregnancy

This medicine should not be taken during pregnancy. If you have already planned a pregnancy, you should consult with your doctor.

Breast Feeding

It is not recommended in patients who are breastfeeding. It may affect the newborn baby.

Driving

It may affect your driving ability if your blood sugar is lowered (hypoglycaemia) or raised (hyperglycaemia) or if you develop visual problems as a result of such conditions. Be cautious if you opt to drive.

Alcohol

It would help if you strictly restricted drinking alcohol when taking this medicine as it may cause severe reactions.

Other General Warnings

Talk to your doctor if

Be very careful about symptoms of low blood sugar like sweating, anxiety, fast heartbeat, headache, intense hunger, restlessness, dizziness, irritability. If you experience these symptoms, immediately eat sugar (do not consume artificial sweeteners)
Eat something as soon as possible. If the symptoms persist even after this, seek emergency medical help
Tell your doctor if:
You have liver or kidney disease
Your body is not able to produce enough red blood cells
All your ongoing medications

Mode of Action

How Does It Work?

It acts on the cells of the pancreas and increases the release of insulin, thereby controlling the levels of blood glucose.

Interactions

Interactions with other medicines

Antifungal medicines (e.g. Fluconazole)
Allopurinol and Sulfinpyrazone (used in the treatment of gout)
Hormonal contraceptive pills
High blood pressure medicines (e.g., Propranolol, Atenolol), ACE inhibitors (e.g. Captopril) and Fibrates (e.g. Clofibrate)
Adrenaline (Epinephrine)
Antibiotics such as Chloramphenicol, Rifampicin, Fluoroquinolones, Tetracyclines or Sulphonamides such as Sulfafurazole and Cotrimoxazole
Cimetidine and Ranitidine (used for stomach ulcers)
Medicines used to prevent blood clotting

Interactions with food items

Interaction with alcoholic beverages is reported.

Dietary Restrictions

Avoid foods with a high glycemic index (white rice, ice-cream, french fries, mangoes). It is advisable to follow a strict diabetic diet.

Dosage

Overdose

Overdose of this medicine may cause low sugar levels (symptoms may include sweating, paleness, headache, faintness or drowsiness). Therefore you should instantly consume sugar (e.g. sugar cubes, sweet juice or sweet candy).

Missed a Dose

If you forget to take medicine, follow the regular dose schedule instead of taking a double dose.

Frequently Asked Questions (FAQs)

Tolbutamide increases the amount of insulin released by your pancreas and thus reduces your blood sugar levels.

Yes, but it should be initiated at lower doses and must be used with caution. Take as prescribed by the doctor.

If you experience any symptoms of dizziness, fainting, sweating and tremors, it may be due to hypoglycaemia. Drink some glucose water, juice or eat sugar or chocolates, then report to the doctor. A regular follow up with your physician is essential.