TOLBUTAMIDE

It is classified as first generation sulfonylurea, sole significant action being lowering of blood glucose level in normal and non-insulin dependent diabetics, but not in insulin depedent diabetics. Its mechanism of action is like Glibenclamide.

Indications

Non-insulin dependent diabetes mellitus (Type II, maturity onset diabetes) whenever dietary treatment alone proves inadequate.

Dosage

1.0 gm a single daily dose before breakfast or the first substantial meal. If more than 1.0 gm daily is required, the rest can be taken before the evening meal. Max : 0.5-2 gm. daily.

Contra-Indications

Insulin dependent diabetes mellitus (Type 1, juvenile diabetes). diabetic coma diabetic metabolic decompensation (ketoacidosis), severe impairment of renal function, hypersensitivity.

Special Precautions

Compliance to diet and regular medication are of utmost importance for success of treatment. Altered alertness and capacity to react may be impaired. Driving vehicle or to operate machinery. Alcohol might attenuate or potentiate effect of tolbutamide. Paediatrics: Should not be used. Pregnancy & Lactation: Should not be used. Elderly: Safe.

Side Effects

Nausea, sensation of gastric fullness, transient changes of haemotopoietic system. Hypersensitivity skin reactions.

Drug Interactions

Hypoglycaemic effect enhanced by dicoumarol, clofibrate, chloramphenicol & cyclophosphamide & effect reduced by corticosteroids, adrenaline, oral contraceptives & thiazide diuretics.