Does Tolinase (tolazamide) cause side effects?
Tolinase (tolazamide) is a prescription diabetes medication used with diet and exercise to reduce blood glucose levels in adult patients with type 2 diabetes mellitus. Other diabetes drugs are sometimes used in combination with Tolinase. Tolinase’s initial effect is to increase beta-cell insulin secretion.
Tolinase causes the pancreas to produce insulin and increases the body's response to it. Tolinase also may decrease the rate of hepatic glucose production, increase insulin receptor sensitivity, and increase the number of insulin receptors. The brand name Tolinase is discontinued.
Common side effects of Tolinase include:
- feeling unwell (malaise),
- spinning sensation (vertigo),
- increased sensitivity to the sunlight (photophobia),
- loss of appetite,
- feeling of stomach fullness,
- muscle weakness, and
- water loss from the body (diuresis).
Serious side effects of Tolinase include:
- disulfiram (Antabuse)-like reactions [for example, severe flushing accompanied by low blood pressure (hypotension) and fast heart rate],
- low blood glucose,
- low blood sodium,
- syndrome of inappropriate antidiuretic hormone secretion (SIADH),
- blood disorders, and
- liver dysfunction.
Drug interactions of Tolinase include quinolone antibiotics, which may result in abnormal changes in blood glucose.
Tolinase may increase blood levels of methotrexate by interfering with the binding of methotrexate to blood proteins.
Anti-retroviral protease inhibitors, a type of anti-HIV medication, may decrease the effectiveness of Tolinase and consequently worsen blood glucose control.
There are no adequate studies of the effects of Tolinase for pregnant women. It is unknown if Tolinase is secreted in breast milk. Consult your doctor before breastfeeding.
What are the imporant side effects of Tolinase (tolazamide)?
Side effects associated with tolazamide therapy include:
- Increase sensitivity to the sunlight (photophobia),
- Sensations of stomach fullness
- Muscle weakness
- Water loss from the body (diuresis)
Possible serious side effects of tolazamide include:
- Disulfiram (Antabuse)-like reactions (for example, severe flushing accompanied by low blood pressure (hypotension) and tachycardia
- Low blood glucose
- Low blood sodium
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Blood disorders
- Liver dysfunction
Tolinase (tolazamide) side effects list for healthcare professionals
Tolinase (tolazamide) Tablets have generally been well tolerated. In clinical studies in which more than 1,784 diabetic patients were specifically evaluated for incidence of side effects, only 2.1% were discontinued from therapy because of side effects.
Hypoglycemia: See prescribing information.
Gastrointestinal Reactions: Cholestatic jaundice may occur rarely; Tolinase (tolazamide) Tablets should be discontinued if this occurs. Gastrointestinal disturbances, eg, nausea, epigastric fullness, and heartburn, are the most common reactions and occurred in 1% of patients treated during clinical trials. They tend to be dose-related and may disappear when dosage is reduced.
Dermatologic Reactions: Allergic skin reactions, eg, pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions, occurred in 0.4% of patients treated during clinical trials. These may be transient and may disappear despite continued use of Tolinase (tolazamide) ; if skin reactions persist, the drug should be discontinued.
Porphyria cutanea tarda and photosensitivity reactions have been reported with sulfonylureas.
Hematologic Reactions: Leukopenia, agranulocy-tosis, thrombocytopenia, hemolytic anemia, aplas-tic anemia, and pancytopenia have been reported with sulfonylureas.
Metabolic Reactions: Hepatic porphyria and disul-firam-like reactions have been reported with sul-fonylureas; however, disulfiram-like reactions with Tolinase (tolazamide) have been reported very rarely.
Cases of hyponatremia have been reported with tolazamide and all other sulfonylureas, most often in patients who are on other medications or have medical conditions known to cause hyponatremia or increase release of antidiuretic hormone. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been reported with certain other sul-fonylureas, and it has been suggested that these sul-fonylureas may augment the peripheral (antidiuretic) action of ADH and/or increase release of ADH.
Miscellaneous: Weakness, fatigue, dizziness, vertigo, malaise and headache were reported infrequently in patients treated during clinical trials. The relationship to therapy with Tolinase (tolazamide) is difficult to assess.
What drugs interact with Tolinase (tolazamide)?
The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, and beta-adrenergic blocking agents.
When such drugs are administered to a patient receiving Tolinase (tolazamide), the patient should be closely observed for hypoglycemia. When such drugs are withdrawn from a patient receiving Tolinase (tolazamide) , the patient should be observed closely for loss of control.
Certain drugs tend to produce hyperglycemia and may lead to loss of control. These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympa-thomimetics, calcium channel blocking drugs, and isoniazid. When such drugs are administered to a patient receiving Tolinase (tolazamide), the patient should be closely observed for loss of control. When such drugs are withdrawn from a patient receiving Tolinase (tolazamide) , the patient should be observed closely for hypoglycemia.
A potential interaction between oral miconazole and oral hypoglycemic agents leading to severe hypoglycemia has been reported. Whether this interaction also occurs with the intravenous, topical or vaginal preparations of miconazole is not known.
In a bioassay for carcinogenicity, rats and mice of both sexes were treated with tolazamide for 103 weeks at low and high doses. No evidence of car-cinogenicity was found.
Pregnancy Category C. Tolinase (tolazamide) , administered to pregnant rats at ten times the human dose, decreased litter size but did not produce terato-genic effects in the offspring. In rats treated at a daily dose of 14 mg/kg no reproductive aberrations or drug related fetal anomalies were noted. At an elevated dose of 100 mg/kg per day there was a reduction in the number of pups born and an increased perinatal mortality.
There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, Tolinase (tolazamide) is not recommended for the treatment of the pregnant diabetic patient. Serious consideration should also be given to the possible hazards of the use of Tolinase (tolazamide) in women of child bearing age and in those who might become pregnant while using the drug.
Because recent information suggests that abnormal blood glucose levels during pregnancy are associated with a higher incidence of congenital abnormalities, many experts recommend that insulin be used during pregnancy to maintain blood glucose levels as close to normal as possible.
Prolonged severe hypoglycemia (four to ten days) has been reported in neonates born to mothers who were receiving a sulfonylurea drug at the time of delivery. This has been reported more frequently with the use of agents with prolonged half-lives. If Tolinase (tolazamide) is used during pregnancy, it should be discontinued at least two weeks before the expected delivery date.
Although it is not known whether tolazamide is excreted in human milk, some sulfonylurea drugs are known to be excreted in human milk. Because the potential for hypoglycemia in nursing infants may exist, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. If the drug is discontinued and if diet alone is inadequate for controlling blood glucose, insulin therapy should be considered.
Safety and effectiveness in children have not been established.
Elderly patients are particularly susceptible to the hypoglycemic action of glucose lowering drugs. Hypoglycemia may be difficult to recognize in the elderly. The initial and maintenance dosing should be conservative to avoid hypoglycemic reactions.
Elderly patients are prone to develop renal insufficiency, which may put them at risk of hypoglycemia. Dose selection should include assessment of renal function.
Tolinase (tolazamide) is used with diet and exercise to reduce blood glucose levels in adult patients with type 2 diabetes mellitus. Other diabetes drugs are sometimes used in combination with Tolinase. Tolinase’s initial effect is to increase beta-cell insulin secretion. Common side effects of Tolinase include dizziness, fatigue, headache, feeling unwell (malaise), spinning sensation (vertigo), increased sensitivity to the sunlight (photophobia), itching, rash, hives, loss of appetite, constipation, diarrhea, feeling of stomach fullness, heartburn, nausea, vomiting, muscle weakness, and water loss from the body (diuresis). There are no adequate studies of the effects of Tolinase for pregnant women. It is unknown if Tolinase is secreted in breast milk. Consult your doctor before breastfeeding.
Multimedia: Slideshows, Images & Quizzes
Type 2 Diabetes: Signs, Symptoms, Treatments
Learn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Find out why thirst, headaches, and...
Diabetes: What Raises and Lowers Your Blood Sugar Level?
Want to lower your blood sugar? Learn to better control your glucose levels by preventing blood sugar spikes and swings to avoid...
Diabetes Nerve Pain: Improving Diabetic Peripheral Neuropathy
Learn how to cope with the symptoms of diabetic peripheral neuropathy through pain management exercises. Find relief for diabetic...
Diabetes: How Blood Sugar Levels Affect Your Body
High blood sugar can be a sign of diabetes or prediabetes. The drugs that treat it sometimes cause low blood sugar too. WebMD...
Foot Health: Reasons You Feel Burning in Your Feet
The feeling of burning in your feet isn't just an annoyance. It might also be a sign of a more serious condition. Find out more...
Diabetes Tips: Managing and Living With Diabetes
If you have either type 1 or type 2 diabetes, you need to approach life differently. Learn nutrition tips to control blood sugar,...
How Diabetes Can Affect Your Feet
Learn more about diabetes related foot problems. For people with diabetes, too much glucose in the blood can cause serious foot...
Prediabetes: You Can Turn It Around
Prediabetes can be a wake-up call. Click through to find out what you can do if you have it.
Diabetes: 12 Ways Too Much Sugar Harms Your Body
The bitter truth: How too much sugar can harm your physical and mental health.
Diabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Discover the best and worst meals for diabetes-savvy dining. See how to avoid carbs and control your blood sugar with healthier...
Type 2 Diabetes: Test Your Medical IQ
What causes type 2 diabetes? Can it be prevented? Take this online quiz and challenge your knowledge of this common condition....
Diabetes Quiz: Test Your Medical IQ
Take the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do...
Diabetes Travel: Tips for Better Diabetes Control
Diabetes shouldn't stop you from traveling! Learn tips for packing diabetic supplies, controlling blood sugar while changing time...
Diabetes Diet: 11 Low-Sugar Drink Ideas
Searching for low-sugar drink ideas? This pictures slideshow has eleven beverages ideal for people with diabetes and those...
Diabetes: 15 Famous Celebrities With Diabetes
See pictures of celebrities that have been diagnosed with type 1 or type 2 diabetes including Mary Tyler Moore, Salma Hayek, and...
Slideshow: Diabetes Management in 10 Minutes
Learn 10 simple ways to better manage your diabetes. See tips for controlling blood sugar, diet and exercise and other helpful...
Diabetes: Guide to Diabetic Peripheral Neuropathy
Diabetes can damage the nerves that help you feel pain, heat, and cold, especially in your feet. Learn about the symptoms of...
10 Muscle-Building Exercises for Diabetes
Watch this slideshow on Diabetes and Exercise. If you have diabetes, see how strengthening your muscles with these 10 weight...
Diabetes: Diabetic Peripheral Neuropathy Treatment
This nerve damage is a common complication of both type 1 and type 2 diabetes. Find out how to prevent it, slow its progression,...
Related Disease Conditions
Normal Blood Sugar Levels In Adults with Diabetes
People with diabetes can manage and prevent low or high blood sugar levels (hyperglycemia or hypoglycemia) by keeping a log of your blood sugar levels when you are eating and fasting and eat foods that are high in carbohydrates and sugar, for example, buttered potatoes, candy, sugary desserts, and fatty foods. Blood tests, for example, the hemoglobin A1c test (A1c test) and urinalysis can diagnose the type of diabetes the person has. Diabetes during pregnancy, called gestational diabetes, should be managed by you and your OB/GYN or another healthcare professional. Extremely high levels of blood glucose in the blood can be dangerous and life threatening if you have type 1, type 2, or gestational diabetes. If you or someone that you are with has extremely high blood glucose levels, call 911 or go to your nearest Urgent Care or Emergency Department immediately. To prevent and manage high blood glucose levels in people with diabetes keep a log of your blood sugar levels, eat foods that are high in carbohydrates sugar, for example, buttered potatoes, candy, sugary deserts, and fatty foods that you can share with your doctor and other healthcare professionals.
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Type 2 Diabetes Diet Plan
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
Pregnancy and Gestational Diabetes
Gestational diabetes is a form of diabetes that can occur during pregnancy. Pregnant women with gestational diabetes have not had the condition prior to becoming pregnant. Usually, gestational diabetes has no symptoms or signs and of gestational diabetes. Gestational diabetes can cause insulin resistance, hypoglycemia, hypoglycemia, and diabetic ketoacidosis. Treatment of gestational diabetes is managing the condition by checking your blood sugar as recommended, diet changes, getting enough exercise, and monitoring your baby's growth.
Diabetes-Related Dental Problems
Second Source WebMD Medical Reference
Type 2 Diabetes: Diagnosing Diabetes
Second Source WebMD Medical Reference
Second Source WebMD Medical Reference
Diabetes Symptoms in Women
Diabetes symptoms in women include vaginal itching, pain, or discharge, loss of interest or pain after having sex, polycystic ovarian syndrome (POS), and urinary tract infections or UTIs (which are more common in women. Symptoms of diabetes that are the same in women and men are excessive thirst and hunger, bad breath, and skin infections, darkening of skin in areas of body creases (acanthosis nigricans), breath odor that is fruity, sweet, or acetone, and tingling or numbness in the hands or feet, blurred vision, fatigue, tingling or numbness in the hands or feet, wounds that heal slowly, irritability, and weight loss or gain. Complications of type 1 and type 2 diabetes are the same, for example, skin, eye, and circulation problems, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), ketoacidosis, and amputation. If diabetes is not managed a person may not survive.
Type 2 Diabetes
Type 2 diabetes is a chronic condition that may be reversible with diet and lifestyle changes. Symptoms include excessive thirst, frequent urination, weight loss, fatigue, and an unusual odor to your urine. Most people don't know they have type 2 diabetes until they have a routine blood test. Treatment options include medications, a type 2 diabetes diet, and other lifestyle changes.
Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Diabetes Symptoms in Men
Early symptoms of diabetes are different in men, such as low testosterone. In many cases, prediabetes that will progress to type 2 diabetes if it is not treated early.
Prediabetes is a situation where a person's blood sugar levels are higher than they should be, but aren't high enough to be diagnosed with type 2 diabetes. There are no signs or symptoms of prediabetes. Some of the risk factors for prediabetes are high blood pressure, high cholesterol, heart disease, smoking, family history, poor diet, and lack of activity. Diet changes along with other healthy lifestyle changes are important in treating prediabetes.
Type 1 vs. Type 2 Diabetes: Differences
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by: Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.) Consuming too many products with artificial sweeteners (We found out that they are bad for us!) Lack of activity Exercise Stress Genetics While the signs and symptoms of both types of diabetes are the same, which include: Increased urination Increased hunger Increased thirst Unexplained weight loss. However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
Diabetes and Safe Medications for Colds & Flu
If you have diabetes and catch a cold or the flu, can be more difficult to recover from infections and their complications, for example, pneumonia. Home remedies and over-the-counter (OTC) drugs used for the treatment of the signs and symptoms of colds and the flu may affect blood sugar levels in people with diabetes.Some medications are OK to take if you have diabetes get a cold or the flu include nonsteroidal anti-inflammatory drugs or NSAIDs, like acetaminophen (Tylenol) and ibuprofen (Motrin) to control symptoms of fever and pain. Most cough syrups are safe to take; however, check with your pediatrician to see what medications are safe to give your child if he or she has type 1 or 2 diabetes. If you have diabetes and are sick with a cold or flu, you need to check your blood sugar levels more frequently. Continue taking your regular medications. Eat a diabetic low-glycemic index diet rich in antioxidants. To prevent colds and the flu drink at least eight 8 ounce glasses of water a day. To replenish fluids, drink sports drinks like Gatorade and Pedialyte to replenish electrolytes. Avoid people who are sick, sneezing, coughing, or have other symptoms of a cold or flu.
Gestational Diabetes (Diabetes during Pregnancy))
Learning how to avoid gestational diabetes is possible and maintaining a healthy weight and diet before and during pregnancy can help. Discover risk factors, tests and treatments for, and signs and symptoms of gestational diabetes.
How to Prevent Diabetes Naturally
Prediabetes is a condition in which a person has early symptoms of diabetes, but has not yet fully developed the condition. If prediabetes is not treated with lifestyle changes, the person could develop type 2 diabetes. Type 2 diabetes and prediabetes can be prevented with lifestyle changes, for example, eating a healthy diet, getting more exercise, reducing stress, quitting smoking, reducing or managing blood pressure and cholesterol, and managing any other health conditions or risk factors that you may have for developing type 2 diabetes.
Diabetes Foot Problems
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
Eye Problems and Diabetes
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
Types of Diabetes Type 2 Medications
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and exercise. There are nine classes of drugs approved for the treatment of type 2 diabetes. Examples of type 2 oral diabetes medications include acarbose (Precose), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), and metformin (Glucophage). Side effects, drug interactions, warnings and precautions, dosage, and breastfeeding and pregnancy safety information should be reviewed prior to taking any medication.
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
Treatment & Diagnosis
- Diabetes FAQs
- Type 2 Diabetes FAQs
- What if I get COVID-19 with Diabetes?
- Diabetes - An Aspirin A Day
- Diabetes and Eye Disease...See No Evil
- Diabetes - David Meets Goliath
- Exercise Therapy in Diabetes - Part 2
- Diabetes Mellitus - The Work Pays Off
- Diabetes - Foot Care: A Walking Matter
- What Foods to Eat to Reverse Diabetes
- Can You Get Diabetes from Stress?
- Can oral diabetes medications cause impotence?
- Does Diabetes Cause Gum Disease?
- What Is the Treatment for Diabetes Eye Damage?
- Does Celiac Disease Cause Diabetes?
- 6 Frequently Asked Diabetes Question
- What Kind of Candy Can You Eat With Diabetes?
- Can Diabetes Cause Muscle Pain?
- Diabetes Diet
- Top 10 Questions to Ask Your Doctor About Diabetes
- Diabetes: Eating Well with Type 2 Diabetes
- Diabetes: What Can I Eat?
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.