Orinase (Tolbutamide) Dosage and Side Effects
ORINASE (tolbutamide) is an oral diabetes medicine that helps control blood sugar levels. This medication helps your pancreas produce insulin. ORINASE is used together with diet and exercise to treat type 2 diabetes.
Proper Use of this medication
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Follow your doctor's instructions about how often to take ORINASE, and whether or not you should take it with food.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, confusion, irritability, dizziness, or feeling shaky. Always keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency.
If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.
Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.
Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your medication dose or schedule without your doctor's advice.
Use ORINASE regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
ORINASE is only part of a treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Store at room temperature away from moisture, heat, and light.
Seek emergency medical attention or call the Poison Help line. An overdose of ORINASE can cause severe hypoglycemia.
Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).
Take the missed dose as soon as you remember (with food if your doctor instructs you to). 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.
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.
Call your doctor at once if you have:
- severe skin rash, redness, or itching;
- easy bruising or bleeding,
- fever, chills, sore throat, mouth sores;
- pale or yellowed skin, dark colored urine;
- low blood sugar--headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or
- low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.
Common side effects may include:
- heartburn; or
- full feeling.
Warnings and Precautions
Do not use this medicine if you are in a state of diabetic ketoacidosis. Call your doctor for treatment with insulin.
You should not use this medicine if you are allergic to ORINASE, or if you are in a state of diabetic ketoacidosis. Call your doctor for treatment with insulin.
To make sure ORINASE is safe for you, tell your doctor if you have:
- liver disease;
- kidney disease;
- a disorder of your pituitary or adrenal glands;
- an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD);
- a history of heart disease; or
- if you are malnourished.
Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of taking ORINASE.
It is not known whether ORINASE 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 ORINASE.
It is not known whether ORINASE passes into breast milk or if it could be harmful to a nursing baby. You should not breast-feed while you are taking ORINASE.
Interactions with this medication
Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
Avoid exposure to sunlight or tanning beds. ORINASE can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
You may be more likely to have hypoglycemia (low blood sugar) if you take ORINASE with other drugs that can lower blood sugar, such as:
- exenatide (Byetta);
- probenecid (Benemid);
- aspirin or other salicylates (including Pepto Bismol);
- a blood thinner (warfarin, Coumadin, Jantoven);
- sulfa drugs (Bactrim, SMZ-TMP, and others);
- a monoamine oxidase inhibitor (MAOI); or
- insulin or other oral diabetes medications.
This list is not complete, and many other medicines can increase or decrease the effects of ORINASE on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with ORINASE. Not all possible interactions are listed in this medication guide.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.