Orinase
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Accepted at over 60,000 pharmacies nationwide
Generic Name: tolbutamide
(tole BUE ta mide)
What is Orinase?
Orinase is in a class of drugs called sulfonylureas. It is used to help control blood sugar levels.
Orinase is used with diet and exercise to treat type 2 diabetes mellitus. Insulin or metformin (Glucophage) may also be used in combination with tolbutamide, if necessary.
Orinase may also be used for purposes other than those listed in this medication guide.
What is the most important information I should know about Orinase?
Treatment with Orinase may increase the risk of death from cardiovascular disease compared to treatment of diabetes with diet alone or diet plus insulin. Discuss with your doctor the risks and benefits of treatment with tolbutamide.
Know the signs and symptoms of low blood sugar (hypoglycemia), which include headache, drowsiness, weakness, dizziness, fast heartbeat, sweating, tremor, and nausea. Carry a piece of hard candy or glucose tablets with you to treat episodes of low blood sugar.
Follow your diet, medication, and exercise routines closely. Changing any of them can affect blood sugar levels.
Do not change your dose of Orinase without first talking to your doctor.
Avoid alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
What should I discuss with my healthcare provider before taking Orinase?
Before taking Orinase, tell your doctor if you
You may not be able to take Orinase, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Patients 65 years of age and older may have a stronger reaction to Orinase and may require a reduced dose.
Orinase is in the FDA pregnancy category C. This means that it is not known whether tolbutamide will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. Insulin is usually the drug of choice for controlling diabetes during pregnancy.
Orinase passes into breast milk and may cause hypoglycemia (low blood sugar) in a nursing baby. Do not take tolbutamide without first talking to your doctor if you are breast-feeding a baby.
How should I take Orinase?
Take Orinase exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass of water.
Orinase is usually taken before breakfast or the first main meal if it is taken once a day, or before meals if it is taken multiple times each day. Follow your doctor's instructions.
It is important to take Orinase regularly to get the most benefit.
Your healthcare provider may recommend regular monitoring of blood sugar levels with blood or urine tests.
Do not change your dose of Orinase without first talking to your doctor.
Store Orinase at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.
What happens if I overdose?
Seek emergency medical attention.
Symptoms of a Orinase overdose include hunger, nausea, anxiety, cold sweats, weakness, drowsiness, unconsciousness, and coma.
What should I avoid while taking Orinase?
Follow your diet, medication, and exercise routines closely. Changing any of these can affect blood sugar levels.
Avoid alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
Tell your doctor and dentist that you are taking this medication before you undergo surgery.
Do not take any prescription, over-the-counter, or herbal cough, cold, allergy, pain, or weight loss medications without first talking to your doctor.
What are the possible side effects of Orinase?
Stop taking Orinase and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).
Other, less serious side effects from Orinase result mostly from blood sugar levels that are either too high or too low. You should be familiar with the symptoms of both high and low blood sugar levels and know how to treat both conditions. Also, be sure your family and close friends know how to help you in an emergency situation.
Low blood sugar may occur when too much Orinase is taken; when meals are missed or delayed; if you exercise more than usual; during illness, especially with vomiting or diarrhea; if you take other medications; after drinking alcohol; and in other situations.
Hypoglycemia or Low blood sugar has the following symptoms:
- shaking
- headache
- cold sweats
- pale, cool skin
- anxiety; and
- difficulty concentrating.
Keep hard, sugary candy; chocolate; fruit juice; or glucose tablets on hand to treat episodes of low blood sugar.
Increased blood sugar may occur when not enough Orinase is taken; if you eat significantly more food than usual; if you exercise less than usual; if you take other medications; during fever or other illness; and in other situations.
Hyperglycemia or High blood sugar has the following symptoms:
- increased thirst,
- increased hunger, and
- increased urination.
There may be an increased risk of death due to cardiovascular (heart and blood vessels) complications with the use of Orinase when compared to the treatment of diabetes with diet or diet plus insulin. The long-term use of tolbutamide should be discussed with your doctor.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Orinase?
Many other medicines may increase or decrease the effects of Orinase or affect your condition. Before taking tolbutamide, tell your doctor if you are taking any of the following medicines:
- aspirin or another salicylate such as magnesium/choline salicylate (Trilisate), salsalate (Disalcid, others), choline salicylate (Arthropan), magnesium salicylate (Magan), or bismuth subsalicylate (Pepto-Bismol)
- a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), diclofenac (Voltaren, Cataflam), etodolac (Lodine), indomethacin (Indocin), nabumetone (Relafen), oxaprozin (Daypro), naproxen (Anaprox, Naprosyn, Aleve), and others
- a sulfa-based drug such as sulfamethoxazole-trimethoprim (Bactrim, Septra), sulfisoxazole (Gantrisin), or sulfasalazine (Azulfidine)
- a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil)
- a beta-blocker such as propranolol (Inderal), atenolol (Tenormin), acebutolol (Sectral), metoprolol (Lopressor), and others
- a diuretic (water pill) such as hydrochlorothiazide (HCTZ, Hydrodiuril), chlorothiazide (Diuril), and others
- a steroid medicine such as prednisone (Deltasone, Orasone, others), methylprednisolone (Medrol, others), prednisolone (Prelone, Pediapred, others), and others
- a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Prolixin, Permitil), prochlorperazine (Compazine), promethazine (Phenergan), and others
- phenytoin (Dilantin)
- isoniazid (Nydrazid); or
- prescription, over-the-counter, or herbal cough, cold, allergy, or weight loss medications.
You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with Orinase or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Where can I get more information?
Your pharmacist can provide more information about Orinase.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2009 Cerner Multum, Inc. Version: 4.06. Revision date: 04/04/2009.
