Sunday, March 25, 2012

Tolazamide


Generic Name: tolazamide (tole AZ a mide)

Brand Names: Tolinase


What is tolazamide?

Tolazamide is an oral diabetes medicine that helps control blood sugar levels. This medication helps your body respond better to insulin produced by your pancreas.


Tolazamide is used together with diet and exercise to treat type 2 diabetes. Other diabetes medicines are sometimes used in combination with tolazamide if needed.


Tolazamide may also be used for purposes not listed in this medication guide.


What is the most important information I should know about tolazamide?


Do not use this medication if you are allergic to tolazamide, or if you are in a state of diabetic ketoacidosis. Call your doctor for treatment with insulin.

Before taking tolazamide, tell your doctor if you have kidney or liver disease, or a history of heart disease.


Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.


Also watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss. Your blood sugar will need to be checked often, and you may need to adjust your tolazamide dose.


Tolazamide is only part of a complete program of treatment that may also include diet, exercise, weight control, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.


What should I discuss with my doctor before taking tolazamide?


You should not use this medication if you are allergic to tolazamide, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

To make sure you can safely take tolazamide, tell your doctor if you have any of these other conditions:


  • liver disease;

  • kidney disease; or


  • a history of heart disease.




FDA pregnancy category C. It is not known whether tolazamide will harm an unborn baby. Similar diabetes medications have caused severe hypoglycemia in newborn babies whose mothers had used the medication near the time of delivery. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether tolazamide passes into breast milk or if it could be harmful to a nursing baby. Do not take tolazamide without telling your doctor if you are breast-feeding a baby.

How should I take tolazamide?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.


Tolazamide is usually taken once a day, with breakfast or the first main meal of the day. Follow your doctor's instructions.


Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.


Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating.

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.


Also watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.


Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change.


Your doctor may want you to stop taking tolazamide for a short time if you become ill, have a fever or infection, or if you have surgery or a medical emergency.


Ask your doctor how to adjust your tolazamide dose if needed. Do not change your medication dose or schedule without your doctor's advice.

Tolazamide is only part of a complete program of treatment that may also include diet, exercise, weight control, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.


Use tolazamide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.


Store at room temperature away from moisture and heat.

See also: Tolazamide dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A tolazamide overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).


What should I avoid while taking tolazamide?


Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

Tolazamide side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Hypoglycemia, or low blood sugar, is the most common side effect of tolazamide. Symptoms include headache, hunger, weakness, sweating, tremor, irritability, trouble concentrating, rapid breathing, fast heartbeat, fainting, or seizure (severe hypoglycemia can be fatal). Carry hard candy or glucose tablets with you in case you have low blood sugar.


Call your doctor at once if you have a serious side effect such as:

  • chest pain, shortness of breath, feeling like you might pass out;




  • easy bruising or bleeding, unusual weakness; or




  • extreme thirst with headache, nausea, vomiting, and weakness.



Less serious side effects may include:



  • dizziness or weakness;




  • headache, tired feeling;




  • mild nausea, heartburn, full feeling;




  • skin rash, redness, or itching; or




  • increased skin sensitivity to sunlight.



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.


Tolazamide Dosing Information


Usual Adult Dose for Diabetes Mellitus Type II:

Initial dose: 100 mg to 250 mg orally daily with breakfast
Maintenance dose: 100 mg to 1000 mg orally daily with a meal in 1 or 2 divided doses. Dosage adjustments should be made in increments of 100 mg to 250 mg at weekly intervals based on the patient's blood glucose response.

Usual Geriatric Dose for Diabetes Mellitus Type II:

Initial dose: 100 mg orally daily with breakfast


What other drugs will affect tolazamide?


You may be more likely to have hyperglycemia (high blood sugar) if you take tolazamide with other drugs that can raise blood sugar, such as:



  • isoniazid;




  • diuretics (water pills);




  • steroids (prednisone and others);




  • heart or blood pressure medication (Cartia, Cardizem, Covera, Isoptin, Verelan, and others);




  • niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others);




  • phenothiazines (Compazine and others);




  • thyroid medicine (Synthroid and others);




  • birth control pills and other hormones;




  • seizure medicines (Dilantin and others);




  • diet pills or medicines to treat asthma, colds or allergies; and




  • heart or blood pressure medication such as diltiazem (Cartia, Cardizem), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others.



You may be more likely to have hypoglycemia (low blood sugar) if you take tolazamide with other drugs that can lower blood sugar, such as:



  • exenatide (Byetta);




  • probenecid (Benemid);




  • some nonsteroidal anti-inflammatory drugs (NSAIDs);




  • aspirin or other salicylates (including Pepto-Bismol);




  • a blood thinner (warfarin, Coumadin and others);




  • heart or blood pressure medication (Accupril, Altace, Lotensin, Prinivil, Vasotec, Zestril, and others);




  • sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others);




  • a monoamine oxidase inhibitor (MAOI); or




  • other oral diabetes medications, especially acarbose (Precose), metformin (Glucophage), miglitol (Glyset), pioglitazone (Actos), or rosiglitazone (Avandia).



These lists are not complete and there are many other medicines that can increase or decrease the effects of tolazamide on lowering your blood sugar. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More tolazamide resources


  • Tolazamide Side Effects (in more detail)
  • Tolazamide Dosage
  • Tolazamide Use in Pregnancy & Breastfeeding
  • Drug Images
  • Tolazamide Drug Interactions
  • Tolazamide Support Group
  • 0 Reviews for Tolazamide - Add your own review/rating


  • tolazamide Advanced Consumer (Micromedex) - Includes Dosage Information

  • Tolazamide Prescribing Information (FDA)

  • Tolazamide Professional Patient Advice (Wolters Kluwer)

  • Tolazamide Monograph (AHFS DI)

  • Tolazamide MedFacts Consumer Leaflet (Wolters Kluwer)

  • Tolinase Prescribing Information (FDA)



Compare tolazamide with other medications


  • Diabetes, Type 2


Where can I get more information?


  • Your pharmacist can provide more information about tolazamide.

See also: tolazamide side effects (in more detail)



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