Adult Dosing
Diabetes mellitus (Type II )
- Initial: 100 mg PO qd (if blood glucose<200 mg/dL, malnourished, underweight, or elderly)
- Initial: 250 mg PO qd (if blood glucose>200mg/dL)
- If daily dose exceeds 500 mg, give in divided doses bid
- Max: 1000 mg/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Results of the University Group Diabetes Program (UGDP), a long-term prospective clinical trial indicate that oral hypoglycemic drugs are associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. Patients treated for 5-8 yrs with diet plus tolbutamide (1.5 g/day) had a rate of cardiovascular mortality approximately 2.5 times that of patients treated with diet alone. Although drug in study was tolbutamide, from a safety view, it is prudent to consider this to other drugs in the sulfonylurea class
- Risk of severe hypoglycemia; monitor blood glucose periodically
- Administration with alcohol may induce disulfiram-like syndrome with facial flushing and breathlessness
- Infection, stress, or changes in diet may alter requirements for control of blood sugar; monitor patient for signs and symptoms of bacterial, viral, or fungal infection
- Proper patient selection, dosage, and instructions are important to avoid hypoglycemic episodes
Cautions: Use cautiously in
- Hepatic or renal impairment
- Severe cardiovascular disease
- Hypoglycemia
- Malnutrition
- High fever
- Prolonged nausea or vomiting
- Impaired thyroid, pituitary, or adrenal function
- G6PD deficiency
- Geriatric patients
- Co-administration of NSAID and other drugs that are highly protein bound such as salicylates, sulfonamides, probenecid, coumarins, MAOI and beta adrenergic blocking agents
- Other drugs that can produce hyperglycemia including thiazides, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking agents and isoniazid
Pregnancy Category:C
Breastfeeding: Safety unknown; an alternate drug may be preferred, especially while nursing a newborn or preterm infant. During maternal therapy with hypoglycemic agents, monitoring of infant's blood glucose is advisable. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 2 August 2010).
Note: Increased risk of cardiovascular mortality; results of the UGDP trial (See warnings section)
- ENDO: Hypoglycemia, hyponatremia, SIADH
- CNS: Dizziness, vertigo, fatigue
- DERM: Allergic skin reactions (pruritus, erythema, urticaria, morbilliform or maculopapular eruptions), photosensitivity, rash
- GI: Cholestatic jaundice, nausea, epigastric fullness, heartburn, diarrhea, constipation, drug-induced hepatitis, dyspepsia, appetite, nausea, vomiting
- GU: Mild diuresis
- HEMA: Leukopenia, thrombocytopenia, aplastic anemia, agranulocytosis, hemolytic anemia, pancytopenia
- METABOLIC: Hepatic porphyria, disulfiram-like reactions
Pricing data from www.DrugStore.com in U.S.A.
- TOLAZamide 250 MG TABS [Bottle] (MYLAN)
60 mg = $39.77
180 mg = $107.17 - TOLAZamide 500 MG TABS [Bottle] (MYLAN)
30 mg = $50.83
90 mg = $121.54
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
