What is Tolazamide used for?
Tolazamide 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. Tolazamide belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body’s natural insulin.
How should I take Tolazamide?
Take this medication by mouth with breakfast or the first main meal of the day as directed by your doctor, usually once daily. Some patients, especially those taking higher doses, may be directed to take this drug twice a day with the morning and evening meals. The dosage is based on your medical condition and response to treatment.
To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.
If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor’s directions carefully for stopping the old drug and starting tolazamide.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.
Tell your doctor if your condition does not improve or if it worsens (your blood sugar is too high or too low).
How do I store Tolazamide?
Tolazamide is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Tolazamide in the bathroom or the freezer. There may be different brands of Tolazamide that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush Tolazamide down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Precautions & warnings
What should I know before using Tolazamide?
Before taking tolazamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, thyroid problems, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate secretion of antidiuretic hormone-SIADH), electrolyte imbalance (low sodium blood level).
You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.
Limit alcohol while taking this medication because it can increase your risk of developing low blood sugar. Rarely, alcohol can interact with tolazamide and cause a serious reaction (disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol.
It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing.
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially low blood sugar.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may change your diabetes treatment during your pregnancy (such as diet and medications including insulin).
It is unknown if this drug passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding.
Is it safe during pregnancy or breast-feeding?
There are no adequate studies in women for determining risk when using this Tolazamide during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Tolazamide. Tolazamide is pregnancy risk category C according to the US Food and Drug Administration (FDA).
FDA pregnancy risk category reference below:
- A=No risk,
- B=No risk in some studies,
- C=There may be some risk,
- D=Positive evidence of risk,
What side effects can occur from Tolazamide?
Stomach cramps, bloating, heartburn, loss of appetite, constipation, diarrhea, nausea, vomiting, and weight gain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: skin changes (such as darkening, thickening), unusual fatigue, fast/pounding heartbeat, easy bruising/bleeding, mental/mood changes, sudden weight gain, swelling hands/feet, muscle weakness/spasm, yellowing eyes/skin, persistent nausea/vomiting, severe stomach/abdominal pain, dark urine, signs of infection (such as fever, persistent sore throat), seizures.
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.
Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your dosage may need to be increased.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
What drugs may interact with Tolazamide?
Beta-blocker medications (including metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.
Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could affect your blood sugar. Ask your pharmacist about using those products safely.
Tolazamide may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.
Does food or alcohol interact with Tolazamide?
Tolazamide may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with Tolazamide?
Tolazamide may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Tolazamide.
What is the dose of Tolazamide for an adult?
Usual Adult Dose for Diabetes Type 2
Initial dose: 100 to 250 mg orally once a day
-Adjust dose based on blood glucose response
Maintenance dose: Average 250 to 500 mg/day; range: 100 to 1000 mg per day
-For doses greater than 500 mg, the dose maybe divided and given twice a day
Maximum dose: 1000 mg per day
-For patients with a fasting blood glucose less than 200 mg/dL, the usual starting dose is 100 mg per day.
-Patients will generally have no further response to doses greater than 1000 mg/day
-Transferring patients from other antidiabetic regimens should be done conservatively: see dose adjustment section.
Use: As an adjunct to diet to lower blood glucose in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet alone.
Usual Geriatric Dose for Diabetes Type 2
Initial dose: 100 mg orally once a day
Renal Dose Adjustments
Use with caution; initial and maintenance dosing should be conservative to avoid hypoglycemic reactions.
Liver Dose Adjustments
Use with caution; initial and maintenance dosing should be conservative to avoid hypoglycemic reactions.
Elderly, debilitated, or malnourished patient: Initial and maintenance dosing should be conservative to avoid hypoglycemic reactions.
Transferring Patients from other Oral Antidiabetic Therapy:
-If receiving less than 1 g/day of tolbutamide: initial tolazamide dose should be 100 mg orally per day.
-If receiving greater than 1 g/day of tolbutamide: initial tolazamide dose should be 250 mg orally per day.
-Tolazamide 250 mg is approximately equal to chlorpropamide 250 mg.
-Patients should be observed carefully in the first 1 to 2 weeks for hypoglycemia due to the possibility of overlapping effects.
Transferring Patients from Insulin Therapy:
-For patients on 20 units per day or less of insulin: Discontinue insulin and start tolazamide 100 mg orally once a day
-For patients on 20 to 40 units per day of insulin: Discontinue insulin and start tolazamide 250 mg orally once a day
-For patients requiring more than 40 units of insulin per day: Decrease insulin dose by 50% and start tolazamide 250 mg orally once a day.
Adjust tolazamide dose weekly (or more often in the group previously requiring more than 40 units per day).
Take orally once a day in the morning
-For doses greater than 500 mg, divide the dose and take twice a day
-Protect from light
-Hypoglycemia may occur, especially in the elderly, debilitated, or malnourished patient, in patients receiving combination therapy, and/or those with renal, hepatic or adrenal insufficiency; dose reduction of this drug may be necessary.
-This drug should not be used in patients with type 1 diabetes mellitus or diabetic ketoacidosis.
-Hemolytic anemia may occur in glucose 6-phosphate dehydrogenase (G6PD) deficient patients; consider a non-sulfonylurea alternative.
-When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma infection, or surgery, it may be necessary to stop this drug and administer insulin.
Regular clinical and laboratory evaluations are necessary to determine minimum effective dose and detect primary or secondary failure.
-Clinical status should be checked within the first 4 to 8 weeks and regularly, thereafter
-Laboratory monitoring including periodic fasting blood glucose, self-monitoring of blood glucose, and urine testing (i.e., glucose and ketones) should be done more frequently during drug initiation and with changing doses; glycosylated hemoglobin levels (HbA1c) should be done as clinically warranted.
-Patients should understand the importance of exercise and dietary control in the management of their disease.
-Patients should understand that alcohol ingestion, intense or prolonged exercise, skipping meals, illness, or lifestyle changes may increase their risks for hypoglycemia; they should know how to recognize the symptoms of hypoglycemia and be prepared to treat it.
-Patients should be careful about driving and use of machinery, especially when at risk for hypoglycemia.
-Patients should speak with their health care provider during periods of stress such as fever, trauma, or illness, as their diabetes management may need to be changed.
-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.
What is the dose of Tolazamide for a child?
The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.
How is Tolazamide available?
Tolazamide is available in the following dosage forms and strengths:
- Oral tablet.
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.
What should I do if I miss a dose?
If you miss a dose of Tolazamide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Tolazamide Dosage. https://www.drugs.com/dosage/tolazamide.html. Accessed May 28, 2018.
Tolazamide. https://www.webmd.com/drugs/2/drug-8719/tolazamide-oral/details. Accessed May 28, 2018.
Review Date: June 2, 2018 | Last Modified: September 12, 2019