Take tolbutamide tablets with food.
Remember to follow any advice you have been given about what you should or shouldn't eat, and try to take some regular exercise.
Make sure you know how to recognise the symptoms of low blood sugar. These include feeling shaky or anxious, sweating, looking pale, feeling hungry, having palpitations, and feeling dizzy.
|Type of medicine||Sulfonylurea antidiabetic medicine|
|Used for||Type 2 diabetes mellitus|
Insulin is a hormone that is made naturally in your body, in the pancreas. It helps to control the levels of sugar in your blood. If your body does not make enough insulin to meet its needs, or if it does not use the insulin it makes effectively, this results in the condition called diabetes mellitus (sugar diabetes).
People with diabetes need treatment to control the amount of sugar in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat but for other people, medicines like tolbutamide are given alongside the changes in diet.
Tolbutamide works by increasing the amount of insulin that your pancreas produces. It can be given on its own or alongside other antidiabetic medicines or insulin.
Before taking tolbutamide
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking tolbutamide it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have kidney or liver problems.
- If you have been told you have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency. These are rare inherited disorders.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take tolbutamide
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about tolbutamide and a full list of side-effects which you may experience from taking it.
- Take tolbutamide exactly as your doctor has told you. It is often prescribed as a single dose of 1-3 tablets with breakfast, although some people are asked to take two doses a day. Your doctor or pharmacist will tell you which is right for you, and your dose will also be on the label of the pack to remind you. Whether you are asked to take one or two doses each day, you should take the tablets with a drink of water while you are eating a meal (or straightaway afterwards).
- If you forget to take a dose, take it as soon as you remember. However, if when you remember it is nearly time for your next dose, then leave out the forgotten dose. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- It is important that you keep your regular doctor's and clinic appointments. This is so your progress can be monitored. You are likely to need regular check-ups with an eye clinic and a foot clinic as well as with your doctor and diabetes clinic.
- Your doctor may recommend that you test for sugar in your blood or urine regularly to check that your diabetes is being controlled. Your doctor or diabetes nurse will show you how to do this.
- If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.
- Check with your doctor before taking up any new physical exercise, as this will have an effect on your blood sugar levels and you may need to check your blood or urine levels more regularly.
- Drinking alcohol is not advisable with tolbutamide. If you do have a drink, keep well within the recommended alcohol limits, as alcohol will affect the control of your blood sugar.
- If you are due to have an operation or dental treatment, you should tell the person carrying out the treatment that you have diabetes and that you are taking tolbutamide.
- If you get unusually thirsty, pass urine more frequently, and feel very tired, then let your doctor know. Your dose of tolbutamide may need adjusting.
- Make sure you know what it feels like if your blood sugar is too low. This is known as hypoglycaemia, or a 'hypo'. The first signs of hypoglycaemia are feeling shaky or anxious, sweating, looking pale, feeling hungry, having palpitations (a feeling that your heart is pounding), and feeling dizzy. If these happen you should eat or drink something containing sugar or have a snack straightaway. Hypoglycaemia may occur if you miss a meal, if you exercise more than usual, if you are ill, or if you drink a lot of alcohol.
- If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well controlled. Make sure you know what it feels like if your blood sugar is low. You may be advised to check your blood or urine glucose levels before you travel and to have a snack with you on long journeys.
- Treatment for diabetes is lifelong. Continue to take the tablets unless you are advised otherwise by your doctor.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because some medicines may interfere with tolbutamide.
Can tolbutamide cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Tolbutamide side-effects - these rarely occur and are usually mild ||What can I do if I experience this?|
|Feeling or being sick||Stick to simple meals - avoid rich or spicy food. Make sure you take your tablets after you have eaten something|
|Constipation||Eat a well-balanced diet and drink plenty of water|
|Diarrhoea||Drink plenty of water to replace any lost fluids|
|Signs of low blood sugar: feeling shaky or anxious, sweating, looking pale, feeling hungry, feeling that your heart is pounding, feeling dizzy||Eat something containing sugar, such as a biscuit or a sugary drink (not diet), and follow this up with a snack such as a sandwich. Tell your doctor if you notice these symptoms, as your dose may need adjusting|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store tolbutamide
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Tolbutamide® 500 mg Tablets; Kent Pharmaceuticals Ltd, The electronic Medicines Compendium. Dated December 2011.
- British National Formulary; 65th Edition (Mar 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Prof Cathy Jackson